Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.


EKG Master Class

Emily MacNeill, MD

  • Sgarbossa criteria for Acute MI with Left Bundle Branch Block = The presence of deep T wave inversions in leads with a predominantly negative QRS (V1-V3), ST elevations in leads with a predominant R wave (as opposed to QS or rS), Pseudonormalization of previously inverted T waves is suggesstive
  • Right Sided MI = think with ST elevation in inferior leads (II, III, aVF), more suggestive when ST elevation is greater in lead III than in lead II. Right sided MI's are more prone to AV nodal blockade and hypotension
  • Persistant Juvenile Pattern = In young children you can have inverted T waves in the right precordial leads (V1-V3), these will typically become upright as the child ages. However, some adults may have persistant inverted T waves inV1-V3.


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