1. Acute Coronary Syndromes
Paleerat Jariyakanjana, MD
Emergency Physician
Faculty of Medicine
Naresuan University
27 Dec 2012

2. Anatomy

3. Anatomy
LAD: anterior & septal regions
LCx
 some of the anterior wall
 large portion of the lateral wall
RCA:
 right side of the heart with blood
 some perfusion to the inferior aspect of the left
ventricle through the posterior descending
artery

4. DIAGNOSIS

8. http://ecg-interpretation.blogspot.com/2012/07/ecg-interpretation-review-47-normal.html

9. http://lifeinthefastlane.com/ecg-library/basics/left-ventricular-hypertrophy/

10. http://www.learntheheart.com/GALV-Aneurysm.html

11. http://www.heartpearls.com/tag/ecg-in-pericarditis

12. http://www.learntheheart.com/GALBBB.html

13. http://www.emedu.org/ecg/crapsanyall.php

14. http://lifeinthefastlane.com/ecg-library/lmca/

15. http://lifeinthefastlane.com/ecg-library/basics/high-lateral-stemi/

24. Electrocardiography
initial 12-lead ECG within 10 minutes
Inferior wall AMIs: V4R obtained
nondiagnostic tracing: repeated at 15-30
minute intervals

25. Electrocardiography

26. Electrocardiography
ECG in emergency medicine and acute care, 1st ed

27. TREATMENT

28. STEMI: reperfusion
 percutaneous coronary intervention (PCI)
 fibrinolytic therapy
Goals
 PCI: within 90 minutes of ED arrival
 Fibrinolysis: within 30 minutes of ED arrival

32. Reference
Tintinalli's Emergency Medicine, 7e
Tintinalli's Emergency Medicine Manual,
7e
ECG in emergency medicine and acute
care, 1st ed
Critical Decisions in Emergency and Acute
Care Electrocardiography

33. ANY QUESTIONS?