Posterior NSTEMI versus Posterior STEMI

[Abhi13]

I tried my best understanding this but can't figure out 🙁 How would a posterior NSTEMI/subendocardial ischemia would like on a ECG in comparison to Posterior STEMI/Transmural?

I mean, if there is Posterior sub-endocardial ischemia, it will only show ST depression in posterior leads but how would you know on the ECG if you haven't done posterior leads yet? Especially since there will be no reciprocal changes for Posterior NSTEMI/Subendo ischemia?

Or is that because Subendocardial ischemia cannot be localized, meaning it's always diffused. If ST depression is localized on posteriorly done ECG; one should suspectial reciprocal localized STE in anteriorly done ECG?

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[francisco84]

I tried my best understanding this but can't figure out 🙁 How would a posterior NSTEMI/subendocardial ischemia would like on a ECG in comparison to Posterior STEMI/Transmural?

I mean, if there is Posterior sub-endocardial ischemia, it will only show ST depression in posterior leads but how would you know on the ECG if you haven't done posterior leads yet? Especially since there will be no reciprocal changes for Posterior NSTEMI/Subendo ischemia?

Or is that because Subendocardial ischemia cannot be localized, meaning it's always diffused. If ST depression is localized on posteriorly done ECG; one should suspectial reciprocal localized STE in anteriorly done ECG?

This is an area of debate, I.e. Whether sub-endocardial ischemia can be localized. I, personally, don't think it can and you just end up seeing it mostly in lateral leads.

 

[Abhi13]

This is an area of debate, I.e. Whether sub-endocardial ischemia can be localized. I, personally, don't think it can and you just end up seeing it mostly in lateral leads.

Thank you for your reply! I agree ,it is definitely a grey area. I mean what if there is diffused STD with aVR STE; would you consider it NSTEMI and manage it medically; or would you treat it as LMCA/LAD STEMI and activate the Cath? I understand LM insufficiency with diffused STD and aVR STE is suggested as rare case but it can happen.

 

[gyngyn]

Closing. This forum is not for homework help.