30th May 2026

Diagnosis

Investigations

• Immediate Actions: ECG within 10 minutes, assess hemodynamic status, and consider reperfusion therapy (primary PCI or fibrinolysis).
• Symptoms: Central chest pain, radiating to the arm, neck, or jaw, with nausea or syncope.
• Cardiac Biomarkers: Elevated troponins confirm diagnosis but should not delay reperfusion therapy.
• ECG Findings: ST-elevation criteria based on gender and age, and consider posterior STEMI or left main coronary artery obstruction.

Localisation of ST-elevation MI, from:  Image Source: Wikimedia Commons (2020), ECG AVNRT, Licenced under a creative commons licence. Available for free at: https://commons.wikimedia.org/wiki/File:Localisation_of_the_occlusion_in_STEMI.svg (Accessed: 25 April 2026).

Anterior STEMI. From the personal collection of Dr Aung Myat (used with permission)

High lateral STEMI. From the personal collection of Dr Aung Myat (used with permission)

Inferoposterior STEMI example II. From the personal collection of Dr Aung Myat (used with permission)

Inferoposterolateral STEMI example III. From the personal collection of Dr Aung Myat (used with permission)