ECG (Diagnosis)
ECG is normal in 8% of all confirmed MI's
In LBBB see Sgarbossa's Criteria
Cardiac Enzymes
ECG is normal in 8% of all confirmed MI's
In LBBB see Sgarbossa's Criteria
HEART Pathway: https://www.mdcalc.com/heart-pathway-early-discharge-acute-chest-pain
ACS - Risk Stratification
Q waves in V1-V3 over time
STD inf leads
STD in aVL (most common lead to see reciprocal change)
STE V1 (only lead looking at RV)

STE III > II (III more R facing)

STE V1 > V2, STE V1 + STD V2
STD in V1, V2, V3; 
R>S in V1 
Tall R waves in V1-V3 (Q waves on back of heart) w/ upright TWs
Doesn't apply in SVT
Acute coronary syndrome 
Acute coronary syndromes 
Acute chest syndrome
STEMI
Unstable angina
Non-STEMI
ST-segment elevation myocardial infarction
Takotsubo cardiomyopathy