Pericarditis

Diffuse ST elevation, without reciprocal ST depression, mostly in inferior limb leads and lateral precordial leads. This is very typical for pericarditis.

T-Waves

Hyperacute T-waves are often the first manifestation of complete vessel occlusion; they are wide, bulky and prominent. Hyperacute T-waves are not necessarily tall, and small T-waves can still be hyperacute when paired with a low-amplitude QRS complex. De Winter T-waves represent LAD occlusion (a STEMI equivalent) requiring immediate revascularization. Previously inverted T-waves can appear normal and upright in […]

Heart Blocks: A Primer

Heart blocks can be a sign of underlying pathology such as MI, Lyme disease, myocarditis, structural heart disease, pulmonary embolism, autoimmune disease, electrolyte disturbances, medication side effects, Lenegre’s or Lev’s disease, increased vagal tone, or could be a normal variant. Treatment with Atropine is indicated in bradycardic, symptomatic and/or unstable patients with a 1st or […]

The Heart Score

The risk of ACS in patients with negative biomarkers and normal ECGs approaches 0.2%. Prior risk scores, such as TIMI and GRACE, provide little, if any benefit, in risk stratification for ED chest pain patients. The HEART score and pathway can risk stratify patients into three separate categories: low (0-3), moderate (4-6), and high score (> 7). Low-risk patients on […]

Chest Pain in Atrial Fibrillation

This is a great example of how the dichotomy between STEMI and Non-STEMI is false.  They are both due to thrombus in the coronary artery and both are very dangerous.  STEMI and NonSTEMI exist on a spectrum.  Thrombus can lyse and propagate, and NonSTEMI can convert to STEMI.  

Emergency Medicine Kenya Foundation