Recognition
- • ST elevation ≥1 mm in 2 contiguous leads (≥2 mm in V2-V3 men, ≥1.5 mm women)
- • New LBBB with symptoms
- • Reciprocal ST depression
Key findings
- • Anterior: V1-V4 (LAD)
- • Inferior: II, III, aVF (RCA)
- • Lateral: I, aVL, V5-V6
- • Posterior: ST depression V1-V3 + tall R
Clinical importance
- • Time-critical — PCI within 90 min door-to-balloon
- • Mortality risk; mechanical complications
Management pearls
- • MONA-B (cautious O₂)
- • DAPT: aspirin 300 mg + ticagrelor/clopidogrel/prasugrel
- • Anticoagulation
- • PPCI or fibrinolysis ≤12 h
- • Right-sided leads if inferior
