Heart Attack and EKG / ECG

As a Doctor, you should be able to quickly identify if a patient is suffering from myocardial ischemia (Acute Coronary Syndrome). This includes Myocardial infarction (heart attack) and Unstable Angina.

This video, gives a quick overview of the signs and symptoms of Myocardial Infarction (MI), and provides a brief explination of the EKG / ECG findings (ST-Elevation, ST-Depression), and why those findings show up in MI. The last part of the video covers the normal electrophysiology of the heart and how normal EKG's are produced.



Download the Powerpoint
Download the Study Guide

PLEASE BE SURE TO MEMORIZE WHAT LEADS WILL SEE ABNORMALITIES FOR AN MI

The following is being used without requesting permission -- if there are any requests to remove the following material, I most certianly will)
http://www.stritch.luc.edu/lumen/MedEd/MEDICINE/skills/ekg/les4prnt.htm

Myocardial infarction :

Acute

Significant Q wave with typical ST segment elevation in the same lead.

Recent

• Significant Q wave
• Diminished R wave
• Twave inversion
• ST segment elevation

Old

Only characteristic abnormalities of the QRS are found.

• Significant Q wave
• Diminished R wave

Myocardial infarction by site:

Location	QRS abnormalities	Vessel affected
Inferior	II, III, AVF	Terminal branches of  LAD and or Right posterior descending
Anteroseptal	V1, V2	Distal LAD
Anterior	V1, V2, V3, V4	Proximal  LAD
Anterolateral	I, AVL, V4-V6	Distal circumflex
High lateral wall	Lead 1 and AVL	Proximal circumflex branch of LCA
True posterior	No Qwaves. Leads showing reciprocal changes only: Tall R waves, tall T waves and ST depression in V1, V2	Posterior descending
Subendocardial	Non Q wave infarction Difficult to establish with certainty ST-T changes with clinical and laboratory evidence of infarct deeply inverted T waves. prolonged QT interval