51 y/o M with a hx of smoking and HTN presents with acute onset of chest pain….
Is this anteroseptal ischemia or posterior MI?
Some clues to help identify the posterior STEMI:
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The triad of ST depressions, upright Ts, and tall R waves (basically the equivalent of Q-waves)
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Do a posterior EKG!
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You only need 0.5mm elevation in the posterior leads (v7-v9) to make the dx
Posterior MI
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Most common type of missed MI
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often misdiagnosed as NSTEMI
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Only 30% are revascularized in 90 minutes
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Usually associated with inferior or lateral MI due to RCA or circumflex occlusion
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4-10% of STEMIs are isolated posterior STEMI
