Beruflich Dokumente
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MI Imitators
Dana Yost, Senior Paramedic
Paramedic Training
King County, WA
MI Imitators
LBBB
Pericarditis
LVH
Cardiomyopathy
Paced
Acute Myocarditis
Ventricular Rhythms
WPW
Benign Early
Depolarization
Hyperkalemia
Left Ventricular
Aneurysm
Hypothermia
Can be caused by MI
Can mimic MI
May Hide
ST elevation
ST depression
Tall T waves
Inverted T waves
BBB Recognition
Forget About the Notch!
BBB Recognition
Wide QRS
> 120ms
Supraventricular rhythm
Right
Left
BBB Recognition
BBB Recognition
LVH
May Produce
ST elevation
ST depression
Tall T waves
Inverted T waves
May Hide
ST elevation
ST depression
Tall T waves
Inverted T waves
LVH
Does not abnormally widen QRS
LVH Recognition
Step 1
Look in V1 and V2
Pick the deepest negative deflection
Count small boxes of negative deflection in that
lead
Remember that number
LVH Recognition
Step 2
Look in V5 and V6
Pick the tallest positive deflection
Count small boxes of positive deflection
Remember that number
LVH Recognition
Step 3
Add the two numbers together
Suspect LVH if the sum equals 35 or
more
LVH
(V1 or V2) + (V5 or V6) = _____mm
Summary
Summary
Most Common Imitators
LBBB
PACED
LVH