emDocs - November 13, 2017 - Author: Folse M - Edited by: Koyfman A and Long B
"Summary
- Type 1 NSTEMI involves a new, partial occlusion of the cardiac vessel. Type 2 NSTEMI involves a supply-demand deficiency.
- Always check for reciprocal ST-segment elevation when observing ST-segment depression.
- Posterior MI diagnosis requires ST-segment elevation of 0.5mm or greater.
- Upsloping ST-segment depressions with tall T-waves through V1-V6 is a STEMI equivalent.
- The American Heart Association recognizes aVR ST-segment elevation in the setting of anterolateral ST-segment depression as an indication for emergent cardiac catheterization.
- PE and dissection are important mimics of NSTEMI.
- Consider inflammatory markers in suspected cases of myocarditis and pericarditis.
- Differentiation of NSTEMI-mimics that involve a physiologic increase in post-left/right ventricular afterload (HOCM, AI, AS, PAH, COPD) can generally be made by careful examination of the patient’s medical history and clinical presentation."