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Old 10-29-2011
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EKG STEMI with no ST Elevation

When do we know that an ACS has to be treated as a STEMI while the ECG doesnt show ST elevation?

Let us discuss....

Last edited by Seetal; 10-29-2011 at 07:41 PM. Reason: spelling error
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Old 10-29-2011
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Correct Answer

well if ECG doesn't show ST elevation then either it is a Un stable angina or NSTEMI then we have to go for cardiac enzymes if cardiac enzymes(Troponin & CK-MB) are elevated then it is NSTEMI while if they are not elevated then it is Unstable Angina:

If it is NSTEMI We have to give patient Aspirin,b blocker,Nitrates and HEPARIN(most importantly) n GP IIb/IIIa inhibitors.this is the main therapy.

While if it is Unstable angina:Then we have to give Aspirin,b blocker, n Nitrates along with Oxygen n morphine.....

I hope I tried my best if any further questions regarding this n if i will be able to answer then most welcome>>>>>>>>>>
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Old 10-30-2011
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go for cardiac enzymes as far as i know.....though cant explain further....
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ACS has three categories (STEMI, NSTEMI and UA) but what i was talking about how do we know when its a STEMI when ECG doesnt show ST elevation?

answer: look at leads V1 and V3 they could be showing tall T waves and ST depression. this is because they are posterior descending MI. the only way to see an ST elevation in the leads are by doing an ECG reading with additional leads 7-9. readings in leads V1 to V3 would actually show the opposite of what's happening because of its position. cool huh?

ps: this was a kaplan qbank question too. but yeah the answer was the same tho, immediate aspirin even when ECG showed ST depression in leads V1 and V3 with tall T waves.
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Old 10-30-2011
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yeah remember being taught abt it during our ward rounds...thanks for reminding
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Quote:
Originally Posted by sonu.agarwall View Post
yeah remember being taught abt it during our ward rounds...thanks for reminding
yup ure welcome!
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Old 10-30-2011
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got it well i didn't about that concept u r rit n thanks for telling me.........
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