13 ste-mimics part4
TRANSCRIPT
![Page 1: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/1.jpg)
12-Lead Electrocardiographya comprehensive course
Adam Thompson, EMT-P, A.S.
STE-Mimics
Part 4
![Page 2: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/2.jpg)
Acute Pericarditis
• Inflammation of the pericardium (pericardial sac).
• May present with global STE• STE may appear pronounced due to PR-
depression. • Tip - STE will be present in reciprocal leads• aVR will present with ST-depression
![Page 3: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/3.jpg)
Acute Pericarditis
• Stage Ieverything is UP – ST elevation in almost all leads
• Stage IITransition – "pseudonormalization"
• Stage IIIEverything is DOWN – inverted T waves
• Stage IV Normalization.
![Page 4: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/4.jpg)
Acute Pericarditis
Stage 1 Stage 2 Stage 3
![Page 5: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/5.jpg)
Acute Pericarditis
![Page 6: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/6.jpg)
Acute Pericarditis
![Page 7: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/7.jpg)
Acute Pericarditis
![Page 8: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/8.jpg)
Hyperkalemia
• Peaked, usually narrow, symmetrical T waves
• Severe hyperkalemia may present with straight line from tip of S wave (nadir) to peak of T wave, AKA Sine wave.
• Sometimes presents with wide complexes, possibly lacking P waves. Z-Fold pattern is common with severe hyperkalemia.
• Use medical history to help determine cause.
![Page 9: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/9.jpg)
Hyperkalemia
• Hyperkalemia = High Potassium Level– Peaked T-Waves
• May mimic an acute MI
– Sine Waves• Sign of lethally high potassium level
Sine Wave
Peaked T-Wave
![Page 10: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/10.jpg)
Hyperkalemia
![Page 11: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/11.jpg)
Hyperkalemia
![Page 12: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/12.jpg)
Hyperkalemia
![Page 13: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/13.jpg)
Hyperkalemia
![Page 14: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/14.jpg)
Osborn Waves
• Sometimes called “J-Waves”• Indicates HYPOTHERMIA• May be associated with bradycardia• Extra wave at the J-Point of the QRS-
complex.
Osborn Waves
![Page 15: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/15.jpg)
STE-Mimics
• Take a big look at the entire clinical picture.
• Often, a pathology has not read up on what it is suppose to look like on an ECG, and breaks all the rules.
![Page 16: 13 ste-mimics part4](https://reader036.vdocument.in/reader036/viewer/2022062303/55654c6dd8b42a9b4c8b4e64/html5/thumbnails/16.jpg)
END
• Up next Ischemia, Injury, & Infarct