209. Chest Pain and Subtle ST Segment Elevation

  1. Christopher P. Holstege MD1,2,3,
  2. Alexander B. Baer MD1,4,
  3. Jesse M. Pines MD, MBA, MSCE5,6 and
  4. William J. Brady MD7,8,9

Published Online: 3 AUG 2011

DOI: 10.1002/9781444397994.ch209

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

How to Cite

Holstege, C. P., Baer, A. B., Pines, J. M. and Brady, W. J. (eds) (2011) Chest Pain and Subtle ST Segment Elevation, in Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444397994.ch209

Editor Information

  1. 1

    Division of Medical Toxicology, University of Virginia School of Medicine, Charlottesville, VA, USA

  2. 2

    Blue Ridge Poison Center, University of Virginia School of Medicine, Charlottesville, VA, USA

  3. 3

    Departments of Emergency Medicine & Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

  4. 4

    Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA

  5. 5

    Center for Health Care Quality, George Washington University, Washington, DC, USA

  6. 6

    Departments of Emergency Medicine and Health Policy, George Washington University, Washington, DC, USA

  7. 7

    Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA

  8. 8

    Center for Emergency Management, University of Virginia Health System, Charlottesville, VA, USA

  9. 9

    Charlottesville-Albemarle Rescue Squad & Albemarle County, Fire Rescue, Charlottesville, VA, USA

Publication History

  1. Published Online: 3 AUG 2011
  2. Published Print: 12 AUG 2011

ISBN Information

Print ISBN: 9781444333473

Online ISBN: 9781444397994

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Keywords:

  • Case 99, chest pain - and subtle ST segment elevation;
  • diagnosis - subtle ST elevation myocardial infarction, with reciprocal change;
  • discussion of patient's 12-lead ECG - subtle ST segment elevation, in inferior leads;
  • reciprocal ST segment depression - reciprocal change, as ST segment depression in leads separate;
  • reciprocal change in setting of transmural acute myocardial infarction (AMI) - patient with increased chance of poor outcome;
  • reciprocal ST segment depression - in electrocardiographic diagnosis of STEMI, specificity and a positive predictive value of 93%;
  • inferior AMI patients with precordial ST segment depression - elevation in right ventricular leads;
  • large prehospital chest pain population, and 12-lead ECG analysis - that reciprocal ST segment depressions, supported diagnosis of AMI