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Evaluation

Scientific Assembly

Track Session

Session: Session 309

Am I Missing an MI? An Update on Three Difficult Myocardial Infarctions

Monday, April 24, 2023
4:15 PM – 4:35 PM CST
Location: Salon D-3rd Floor
CE: 0.25 Credits
Cardiovascular Critical Care Recorded Session
Disclosure(s):
Jerry W. Jones, MD, FAAEM: No financial relationships to disclose
Clinically, the patient has all the signs of an acute MI - except for one thing: a diagnostic ECG. What am I not seeing? Is there something else I should be looking for?

During the last 10 years, we have discovered that many "non-STEMIs" were actually complete coronary artery occlusions. But the patient was incorrectly categorized and failed to receive optimal management. Three different presentations of acute coronary occlusions will be presented and the skills to recognize these difficult presentations will be defined and addressed in detail. This will include discussion of the newly recognized Aslanger pattern, the “South African Flag Sign” (isolated occlusion of the first diagonal branch) and an early STEMI presenting as ST depression.



Learning Objectives:

  • Recognize three very subtle, easy-to-miss signs of acute myocardial infarction.
  • Implement a plan to more effectively manage a chest pain patient when the initial ECG fails to meet STEMI criteria.