Key concepts covered in the cardiology webinar today:
Chest pain stratification scores :
ED ACS ( accelerated chest pain pathways)
Aus cardiology society cp guide - high intermediate and low risk
Approach to an ECG:
PR / elevation - depression / P Ta elevation
QRS - rule out BBB / LVH / hocm / ER / brugada first
Then consider ST segment for stemi or nonstemi
Drugs / dig / electrolytes / toxin
STEMI patterns on the ECG, localization of the lesion eg anterolateral stemi, correlation with specific coronary vessels involved
STEMI differential - note not all stemi has reciprocal change
Early depolarization ( low medium high risk)
Ventricular hypertrophy / hocm
Arrhythmia eg brugada
Takotsubo - 💔 broken heart syndrome
Inflammation - pericarditis / myocarditis
Osbourne waves / hypothermia
Vasospasm - prinzmetal angina
AVR - ‘the death lead’ - elevation > 1mm and more than V1 with widespread Sr depression = Left main stem equivalent lesion.
Posterior STEMI diagnosis - look for V1-2 st depression r/s ratio > 1 and upright T waves
Right ventricular STEMI diagnosis
Atrial infarction with PTa elevation - increased mortality
RBBB - acs and STEMI diagnosis is complicated.
AF and flutter guidelines - rate vs rhythm control, drugs to use, chadsvasc2, hasbled score
MJA AF guideline.
Still another 150 ecg’s to go !
Happy studying ! 💔 🖤😎