12 lead STEMI mimics

Question	Answer
Left bundle branch block, diagnostic criteria	QRS > 0.12s Dominant S wave in V1 Broad monophasic R wave in lateral leads Absence of Q waves in lateral leads Prolonged R wave peak time >.06s in V5-6 Bonus: ST segments and T waves always go in the opposite direction to the main vector of the QRS complex
Right bundle branch block, diagnostic criteria	Broad QRS RSR' pattern in V1-3 (M-shaped QRS) Wide, slurred S wave in lateral leads Bonus: chest leads largely unaffected
Pericarditis, diagnostic criteria	Widespread concave ST elevation in PR depression through most of limb leads and precordial leads (V2-6) Reciprocal ST depression and PR elevation in aVR Sinus tachy common
Benign early repolarisation, diagnostic features	Widespread concave ST elevation, most prominent in V2-5 Notching or slurring of the J point Prominent, slightly asymmetrical T waves that are concordant with the QRS complex Degree of ST elevation is modest in comparison to T wave amplitude (<25% of T wave height in V6) No reciprocal ST depression to suggest STEMI (except in aVR)
Left ventricular hypertrophy, diagnostic criteria	S wave depth in V1 + R wave height in V5-6 is >35mm, plus: Increased R wave peak time >.05s in V5or 6 ST segment depression and T wave inversion in the left sided leads

Resource summary

	Created by Amelia Tuffley over 5 years ago