Calc Function

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    Patent Pending

    Subtle Anterior STEMI Calculator

    Differentiates early repolarization from anterior STEMI.
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    BEFORE USE

    NOTE: Cannot be used with LVH or bundle branch block. Not to be used for obvious anterior STEMI.
    Pearls/Pitfalls
    mm
    msec
    mm
    About the Creator
    Dr. Stephen Smith
    Content Contributors
    • Stephen Smith, MD

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    Critical Actions

    subtle anterior stemi
    • ST elevation at 60 ms after the J-point in lead V3, relative to the PR segment
      • Find the J-point (lower blue arrow)
      • Locate the time point of that J-point (left-hand green arrow)
      • Go 60 ms to the right (right hand green arrow)
      • Go up to the tracing (upper blue arrow)
      • Draw a horizontal line at this point (upper green line)
      • Draw a horizontal line at the level of the PR interval (lower green line)
      • Measure the voltage between these two lines (in this case, 3.5 mm or 0.35 mV)
    • R-wave amplitude in lead V4
      • Mark the level of the PR interval (lower green line)
      • Mark the top of the R-wave (upper green line)
      • Measure the distance between the two: (17 mm of grid lines plus + 7.5 mm off the grid, Total = 24.5 mm
    Content Contributors
    • Stephen Smith, MD