How are we going to differentiate in case 6 that MI is in inferior wall and anterior leads changes are reciprocal or posterior wall MI is present while ignoring completely elevation in contiguous leads in inferior wall?
Sterling. Thank you. 8:25 Lead Grouping 17:33 Reciprocal Lead Groups 17:45 : Contiguous leads (two or more leads that view similar areas of the heart. They follow lead grouping. Eg II, III and aVF look at the inferior part of the heart)
I am a bit confused, didn't you explain in a different vid that in order to verify whether an ST-elev. is a "true" ST-elev., one would need to check for the smiley vs. frowning faces? In 21:45, aren't there only smileys? Or isn't that rule valid here since we have the symmetrical, broad-based, hyperacute T waves and reciprocal changes? Answer highly appreciated!
Great question and thanks for watching. ST segment elevation and T wave morphology are both things to look for on the ECG. The shape of the T wave can independently raise suspicion of ongoing myocardial ischemia. In this example, there is significant STE in multiple contiguous leads and therefore STEMI is diagnosed. The presence of smiley face ST segments does not negate the finding of STE. Indeed, there are causes of STE that are not due to OMI and sometimes the shape of the ST segment can help us differentiate them from the more sinister STEMI.
