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Subtle Anterior STEMI Calculator

Differentiates early repolarization from anterior STEMI.

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

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