Key concepts covered in the cardiology webinar today:

Chest pain stratification scores :
TIMI
HEART
ED ACS ( accelerated chest pain pathways)
Aus cardiology society cp guide – high intermediate and low risk

Approach to an ECG:
Rate
Rhythm
Axis
PR / elevation – depression / P Ta elevation
QRS – rule out BBB / LVH / hocm / ER / brugada first
Then consider ST segment for stemi or nonstemi
Qtc
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

ELEVATION mnemonic
Electrolytes
Early depolarization ( low medium high risk)
LBBB
Ventricular hypertrophy / hocm
Aneurysm
Arrhythmia eg brugada
aortic dissection
Takotsubo – 💔 broken heart syndrome
Intracranial haemorrhage
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
Increased mortality

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 ! 💔 🖤😎