Stemi criteria

1. STEMI on ECG New ST elevation at J-point in 2 contiguous leads with cut-points: ≥ 0.2 mV in men ≥ 40 years in leads V2 - V3 ≥ 0.25 mV in men < 40 years in leads V2 - V3 ≥ 0.15 in women in leads V2 - V3 ≥ 0.1 mV in all other leads In the absence of LVH and LBBB examples of ST-elevation in MI

2. Criteria Paul Sia for diagnosing STEMI on ECG

3. 3rd Universal Definition of MI (2012)

4. STEMI on ECG New ST elevation at J-point in 2 contiguous leads with cut-points: ≥ 0.2 mV in men ≥ 40 years in leads V2 - V3 ≥ 0.25 mV in men < 40 years in leads V2 - V3 ≥ 0.15 in women in leads V2 - V3 ≥ 0.1 mV in all other leads In the absence of LVH and LBBB examples of ST-elevation in MI

5. General pitfalls Beware of baseline ECG abnormalities that may obscure interpretation LBBB refer to Sgarbossa’s criteria LVH J-point elevation syndromes eg, Brugada PE Peri/myocarditis Cardiomyopathy, including Takotsubo Cocaine use Cardiac pacing

6. STEMI location septal V1, V2 inferior II, III, aVF reciprocal changes: I, aVL lateral I, aVL, V5, V6 reciprocal changes: II, III, aVF anterior V3, V4 anteroseptal V1, V2, V3, V4 anterolateral I, aVL, V3, V4, V5, V6 reciprocal changes: II, III, aVF posterior V7, V8, V9 reciprocal changes: V1, V2, V3, V4

7. Anterolateral STEMI ECG 1

8. Inferior STEMI ECG 2

9. ECG 3 Inferolateral STEMI Horizontal ST depression V1-3 Tall R waves, upright T-waves V2-3

10. ECG 3 + posterior leads Inferior-lateral-posterior STEMI

11. References Bax, Jeroen J., et al. "Third Universal Definition of Myocardial Infarction." Journal of the American College of Cardiology 60.16 (2012): 1581-1598.