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Identification of Acute Myocardial Infarction by 12 Lead EKG.

The purpose of this presentation is to help the learner to identify acute changes on the 12 lead EKG seen in Acute Myocardial Infarction (AMI) and coronary ischemia. 

There are three sections to this presentation. The first includes a review of cardiac anatomy, lead placement and differentiating between myocardial infarct, injury and ischemia. We will review a 12 step process that will help to differentiate acute infarct versus ischemia. The 12 step method involves assessing the EKG for:

1. Regularity
2. Rate
3. Complexes
4. Rhythm changes
5. ST elevation
6. ST depression
7. T wave inversion
8. Pathological Qs
9. R-wave progression
10. Right sided chest lead
11. Imposters
12. Interpretation

The second section involves the grouping of leads to specify location using the location assistant table. This identifies which leads are involved in anterior, septal, inferior, lateral, and posterior. We will also expand on the imposter rhythms that can camouflage findings and review differential diagnosis and treatment options for each.

The final section will consolidate the participants knowledge as they practice their interpretation skills while reviewing example 12 lead EKGs.  We will use the 12 step process and the location assistant tool to interpret the EKG findings and determine if acute infarct, injury or ischemia are present.

The presentation is targeted towards healthcare professionals including physicians, advanced practice nurses or physician assistants, and nurses who would like to further their understanding of 12 lead EKGs. Background knowledge of basic telemetry/rhythm recognition is required.

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