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- เผยแพร่เมื่อ 25 ส.ค. 2024
- An explanation of the pathophysiology underlying the ST elevation/depression that occurs in STEMI and NSTEMI. I'm a first year medical student so take my explanation with a grain of aspirin and comment if you notice any inaccuracies.
Thanks for watching!
The smartest and most logical explanation i have heard about this subject. Congratulations!
Fast or slow, it's a great video. Congratulations. Some people come here thinking that watching this will make them learn, but this is truly about understanding or completing something that they should've checked out (studied) before. Reading, drawing, thinking, listening, repeating. It all makes a part of the same learning process. Would help a lot to speak about the whole potencial of cells (specially myocardium functional cell structure) before. Maybe another small video. Nice work.
this was the best explanation i've ever seen. why didn't you keep making such videos?
I always come back to this video when reviewing Cardiology 💜
Thank You for this!!
Bro u literally saved my time wrapping my head around after watching countless resources. Congratulations keep making these good content
Only video that explains WHY there is ST change in infarction. thank you
ive watched a few of these videos. yours straighten me out. thanks
Thank you so much sir ,’”the electrode records the direction of current on outer cardium “had always missed this point in the whole mechanism ,,ended up confused all the time in non STEMI ..Thank you so much
It is not measuring the charge on the outer myocardium. It is measuring the voltage difference across two electrodes. If the depol wave (current) moves towards the measuring electrode (+), you will see a positive voltage.
It's nice to see a medical student considering physiology at the level of the cell, and down to the ATPase pumps, in discussing ECG anomalies. I genuinely doubt most interns or resies would have a grasp of the physiology like this. Which uni you at?
I’m a paramedic and I understand that. Makes me question some residents . Everything you said makes perfect sense . Great video!
@@austinmuncrief252 I mean to be fair. I study medicine and our focus is in diagnosis the disease and treating it. A physiological understanding is important when studying, but I doubt it in a clinical setting. I doubt anyone is considering this down to each pump and receptor when a patient comes in.
Hey guys , i’m an intern nurse and try to understand how does that happen , do you think i’m obsses 😂💔
What? ALL medical students need to understand this. It's the basics. Residents don't focus on these because they've already gone through it and are now focused on patient care and management.
You've no idea how medical school works?
@@austinmuncrief252 doctors have more complicated pathophysiology and management things to understand.
Best explanation of this subject I have ever heard. Thank you.
In other words am I correct in saying that STEMI is a "relative ST segment elevation" and really depressed basal membrane potential?
Thanks for making this video, really did clear up some misunderstandings I had. Btw, for those who has problems with his speed, you can slow it down to 0.75x. Makes it much easier to hear.
I didn't get the baseline shift thing, anyone?
Good job. Thank you for explanation.
Wow! You explained it so well! You are truelly gifted. Thank you so much. You basically saved my exam!
Gr8 video.. saw few videos of other guys but no one has explained as good as you..
The absolute besttt video on this, this is awesome, thank you🙏🏻
i don't have much to say except, "i love you " for this , you really came through
it's all about theories and nothing is still clearly understood.
but you did a GREAT JOB, GREAT Explanation and it helped me a lot.
keep on !
p.s my english language is good, it would be much easier for others to understand if you speak a little more slower
thanks and keep ahead
Thanks so much for the feedback! And I'm glad you found the video useful :D
Oh, wow! So simple, so smart! A desperate med student is thanking you for this amazing explanation! :D
finally i understand stemi and nstemi, thank you so much, this is only detailed explanation in youtube !
Btw the upward and downward shift in the baseline is because the isoelectric line is made from the electrodes first recording of depolarization, prior to the SA node. In other words, the first wave of depolarization, is where the isoelectric line begins.
This is a better explanation than the one my cardiac physiology professor gave me...
because it is wrong explanation
I have to explain this to my senior tomorrow, cheers dude! Good job 🙂
this helped clear a few things up, thank you. and I didn't think you spoke fast at all but that's probably because I'm also Australian- maybe it's just how we speak?
it was a good video to solidify things after watching a hardcore intense video.. thank u so much. even the hardcore videos on its own confused me but this helped alot
Ornella Flavien what was the hard core video you watched before this one?
This is brilliant! You explain it really clearly. Really helped me understand this topic better. Please make more of these talking a tad slower. Thanks :-)
Thank you for this video, it was very simple and clear :)
very nice explanation . this video should clear all doubts.
awesome! unblemished illustration... thank you so much
I thought my speed was up, he just speaks fast but great explanation. I actually like fast and to the point! haha Thanks!
You have the best explanation than rest! I feel good!
I’m no medic, but I found that easy to understand…, great
i like your videos ! gotta explain this to my mates tomorrow. This helped me a whole lot. Thanks
Thanks for explaination!
Thank u so much it really improved my clariy
Great video
I have never understood this. Most paramedics are trained to look at ischaemic changes and match criteria to determine infarcts. I wonder how many do the extra learning.
Thank you so much!!
Was wondering why there was so many dislikes - this video is intended for med students
Great video!! Helped me alot
fantastic and clear, good speed
thank you for explaining it in a simpler way. :)
This is so wonderful - THANK YOU. Btw, I've ask one of our cardiologist preceptors to explain this, and he couldn't.
Awesome video....great explanation
Why would the baseline shift downwards or upwards so early, if atrial depolarisation is intact? The ischaemic tissue is in the ventricles and not the atriums. One would expect that the isoelectric line stays there where the true baseline is, at least for the P wave..
Good question. I agree the ventricles most often infarct, so we would expect atrial depolarisation to be unaffected. To answer your question, the ST-segment changes occur following tissue infarction, thus shortly after the patient becomes symptomatic and most likely before we conduct an ECG. Now, each electrode records vectors moving though a specific plane of the heart, this plane will transverse both ventricle and atrium. If we have infarcted tissue in the ventricles, this will create a positive vector within the plane of the electrode. Because this vector is constant throughout the cardiac cycle, this constant deflection translates to a shifted baseline which affects the entire tracing. So even if the P wave itself is unaffected, the baseline upon which it is recorded will be affected.
This is my understanding, would you agree?
'traverse'
'transverse'
@@matthewvarhegyi5201 'Tansverse' is not a verb.
Outstanding video! Thanx
Thank you so much
I'm trying to tie this into de winters t waves. help?
why doesn't the necrotic tissue on the left give towards the electrode the same as the right?
Really satisfying and simple explanation compared to most ive tried to read so far. Great video!
But also, are these all theories with none having been proven actually?
It seems like a paradox. It’s just the baseline which shifts due to imbalance in current? Can you explain what changes the baseline?
please add a video on how ecg works....I mean including how electric charges flow in a heart tissue at electron level and I'm always curious on how tht thing works and how every cardiology is able to interpret them....I'm not able to move forward regarding interpretation becoz I don't know how it's getting recorded.kindly help.
Just a quiery:
Isn't Trop T elevated in both MI and Unstable angina?
Only CKMB and LDH are detectable in MI and not in U angina.
Amazing
Nicely explained, well done mate
As you say fibrotic tissue does not show ionic leakge, will it show P and QRS complex. Also tell about change in T wave
Awesome man
What about T wave inversion
So all the NSTEMI generally have, as reasoning, an occlusion of some sort or can be caused also from other things like stress or some medication?
nice explanation
THIS IS GENIUS!!!
Thank you thank you thank you
I love you so much
This really help me understand the deeper level of EKG
Thank you so much for this!
What textbook are you using? I want to know more about this!!
Put the speed to a slow setting :)
what is the meaning of Non-specific ST-T wave changes? is it normal or not?
Why doesnt the infarcted segment keep on sending away depolarisation away from the electrode after QRS? Im guessing it gets into refractory mode? But since it sends out a vector of depo which depresses the ecg nonstop except that moment (during ST) it sounds weird that it stops after QRS?
This part i dont get
I think ECG changes have more of noticeable activity during ventricular systoli in MI .. the current of injury is more evident in this phase .. after qrs heart is inert so ST elevated (returning to actual baseline )
Finally understand it. 👍👏👏👏
Hey, great video! I was wondering why the partial depolarisation moves away from the area of infarct? thanks!
0:25 - 3:41 for ST ELEVATION EXPLANATION
THANK YOU
thank you very much, very good explanation.
But i think the vector of the current will be to the left downward in STEMI.
and I do not if you can explain more or give me a reference to read about the baseline shifting ?
thank you
excellent video
Thanks for the help!!
thanks sooo much
SSOO GREAT!!! MYSTERY SOLVED!
Thanks sir
YAY Jack that makes so much sense :D thankyou
‘We have baseline depression in anterioseptal leads’
Reducing speed to .75 helps 😊
yo cuz you really helped me with my assignment
you speak soooo fast man , like running from a dog!
cheers for the feedback, will keep it in mind for future vids
changing the speed to 0.75 helped!
Aside from speed, your reference to cellular pathology is a welcome and enlightening change from the usual glib spiel that many people feel the unfortunate impulsion to, ahem, regurgitate. Keep up the good work.
Lol, just cuz your foreign ass can't understand English doesn't mean its JACKW's fault. Great video man, keep it up!
@@ontheskies thank you!
This is amazing thanksss ❤️❤️❤️❤️❤️❤️❤️❤️❤️
Good explanation..could you kindly add in your resources (books, any link) where we can get more info... thanks
Hi thanks for the comment. I based the explanation on this textbook: www.amazon.com/Pathophysiology-Heart-Disease-Collaborative-PATHOPHYSIOLOGY/dp/1605477230
Thankyou :)
Thank U for posting this video ...it really helped a lot ...keep going
but I just want to ask a Q >> why the change only appear in the ST segment ?? and thank U ...and Excuse me if the question is "Easy" ..Still in my first steps in Ecg
p,q,r,s,t are the corralating entities for point and segment indicator references. The P wave represents Rt. Atrial anatomically & Rt. atrial depolarization ( electrical activity of the SA ) with each of the subsiquent heart manifestations occuring sequentially ...this you will find, will eventually place the S and following T near the end of that sequence. Terminally the location of the ST segment correspondence is to the ventricular repolarazation electrically and the stemi presented in this case was in the left ventricular wall.
WOW THANKS SO MUCH
Thank you
amazing
Appreciated your explanation, but could not understand what you are saying even at 0.75X
Very Nice Job! I understand more now than when I went in. Yes, it was fast for me too, so that's why I'll watch it 2 more times! Problem solved :)
great...
THX!
👌
Not sure which language is he talking?
speak a bit slowly.. anyway thanks for the vid (y)
Settings > Speed 0.75... much better! :)
goood tip!
The video is good however u speak so fast..:'(
watch at speed 0.75 way better still great vid
View it on 0.75 x