Highlights
- •Five clinical pearls for augmented vector right (aVR) ST-segment elevation (STE) are presented.
- •A mnemonic for differential diagnosis in nonocclusve aVR STE is discussed.
- •A brief review of the evolving literature on the high mortality rate associated with aVR STE is provided.
Abstract
ST-segment elevation myocardial infarction (STEMI) is characterized by ST-segment
elevation in at least 2 contiguous leads, chest discomfort, and the release of biomarkers
requiring emergent revascularization. In 2013, the American College of Cardiology
Foundation/American Heart Association revised STEMI guidelines to include augmented
vector right (aVR) ST-segment elevation to be treated as a STEMI equivalent. However,
aVR ST-segment elevation with multilead ST depression can occur in presentations other
than occlusive myocardial infarctions. The purpose of this clinical feature is to
provide a brief review of aVR ST-segment elevation, explore approaches to clinical
decision making, and provide tools to support nurse practitioners caring for patients
with cardiac issues.
Keywords
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Biography
All authors are affiliated with the Department of Cardiac Sciences, Alberta Health Services in Calgary, Alberta, Canada. Jessica D. Jenkins, MN NP, is a nurse practitioner and can reached at [email protected] Margaret Henninger, MN NP, Mikaela J. Robertson, MN NP, Adrienne Rommens, MN NP, Lisa N. Wieler, MN NP, and Nancy M. Clark, MN NP, are nurse practitioners.
Article info
Publication history
Published online: January 21, 2021
Footnotes
In compliance with standard ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.
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© 2020 Elsevier Inc. All rights reserved.
