![]() STEMI vs Pericarditis - Think STEMI if: Reciprical STD (except V1 or aVR), STE in III > II, horizontal or convex upwards STE, new Q waves, check mark sign (T wave takes off directly from S wave, no real ST segment). - Think pericarditis if: PR depression in multiple leads, PR elevation in aVR, Spodick’s sign (downsloping TP segment) Sgarbossa’s Criteria - Concordant ST elevation > 1mm or concordant ST depression >1mm V1-V3 - 90 % specific - Excessively discordant (>5mm discordant ST change or if ST change >25% S wave) – sensitive but not specific! - Only need one lead, do not need two contiguous leads Tick Paralysis - Commonly misdiagnosed as Guillain Barre Syndrome - Most common in females <8 yo with long hair in April-June - Presents with ascending flaccid paralysis, hyporeflexia, sensory sparing
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