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The ECG is an absolutely critical part of the clinical evaluation of ACS. It is usually the first diagnostic test ordered, rapidly obtained, not invasive, cost-effective, and can be used to identify occlusion MI (OMI).
The earlier in the evolution of OMI that the diagnosis is made, the sooner reperfusion can be achieved. Time is myocardium.
If you take care of patients in an acute care setting, it is important to be an expert in ECG interpretation of OMI. Use the following links to learn more about the ECG in OMI:
Look first for clear ECG evidence of STEMI & OMI:
Understand the typical evolution of ECG findings in occlusion & reperfusion:
Next look closely for subtle ECG evidence of occlusion or ischemia:
STEMI (-) Occlusion MI
STEMI Mimics
KEY PEARL:
KEY PEARL:
The ECGs of many patients with ACS do not show any evidence of ischemia, much less STEMI. Many times, ECG will have "non-specific" abnormalities that are not diagnostic. When you master ECG interpretation, you will find that may "non-specific" abnormalities are more specific than others may think!
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