Additionally ECG leads showing ST depression could be the result of reciprocal (mirrored) changes of other leads showing ST elevation. When the ST segment is depressed this indicates myocardial ischemia (a lack of oxygen to the heart muscle itself). Changes to the ST segment of either depression or elevation must be greater than 2mm (vertically two small boxes). Should the J-point begin higher than the isometric line as seen in figure C, it is referred to as elevated. When the J-point of the ST segment is below the isometric line it referred to as depressed as seen in figure B. Ideally the beginning of the J-point will be vertically equal to the isometric line as seen in figure A below. The J-point is the initial point where line of the ECG ceases having a vertical or diagonal angle and flattens out to become more straight leading to the T-wave. True measurement of the ST segment begins at the "J-point" after the S-wave. The ST segment refers to area of ECG beginning with the end of the "S-wave" and ending with the start of the "T-wave." If ECG assessment is a new subject for the reader or perhaps the reader is just a little rusty, it recommended that you read The Beginner's Guide to Cardiology. Recognition of a STEMI requires some advanced prerequisite knowledge of ECG's and cardiology. Ultimately in laymen's terms, this is a very grave heart attack that a victim's survivability is dependent upon quick and aggressive treatment from all care providers, beginning with First Responders and all the way to the cardiologist. So what exactly is a STEMI? The term STEMI is actually an acronym for (ST segment Elevated Myocardial Infarction). If by some strange miracle you have not, just give it time as the rapid recognition and treatment of STEMI's has become a major focus all around the country. If you have worked in emergency medicine for even just a short amount of time, chances are you have heard the term "STEMI" (pronounced stem-ee). A Guide to STEMIs: Basic 12 lead diagnosis and treatmentīy David Peck, EMT-P STAR Ambulance ServiceĬontributing writer for Public Safety Degrees
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