Posterior STEMI

Definition

History and findings suggestive of acute coronary syndrome.

History/Physical Exam

History and findings suggestive of acute coronary syndrome.

Key 12-Lead Features

• Suspect Posterior MI with marked Precordial ST Depression V1-4 > 1mm (sensitive)
• ST Elevation in V7/8/9 > 0.5mm adds specificity

Key Treatment Points

• Transmit as per current guidelines if believed ischemic
• Convey to PCI capable hospital
• Monitor for 12-lead changes and patient decompensation
• Treat as Acute Coronary Syndrome
• Patient advocacy at the hospital

12 Lead ECG Sample

Further Reading

References

1. Van Gorselen, EOF, et al. Posterior myocardial infarction: The dark side of the moon. 2007.  [Link]