title: The late presenting STEMI: How ECG scores can be used to estimate event time.
abstract: Patients presenting with ST elevation myocardial infarction (STEMI) derive significant benefit from timely percutaneous coronary intervention (PCI). Electrocardiogram (ECG) scoring systems can complement history to estimate the infarction age and inform clinical decision-making.
  
  
  
  A 76year old man presented with eight days of dyspnea on exertion and chest pain. Triage ECG showed ST elevation and Q waves in the anterior leads. The patient was taken for coronary angiography and found to have a 100% occlusion of the left anterior descending artery.
  
  
  
  Determining timing of acute coronary syndromes is challenging. ECG indices aid clinical history by quantifying infarction acuity.
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, CA. Electronic address: zak.loring@ucsf.edu.
authors.forename: Zak
authors.initials: Z
authors.lastname: Loring
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, CA.
authors.forename: Jenny K
authors.initials: JK
authors.lastname: Cohen
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, CA.
authors.forename: Juliet
authors.initials: J
authors.lastname: Morgan
authors.affiliation: Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Yang
authors.affiliation: Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA; Division of Cardiology, Department of Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, CA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Zimmet
mesh_terms: D000368:Aged; D000465:Algorithms; D058070:Asymptomatic Diseases; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D015203:Reproducibility of Results; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity
keywords: Clinical decision-making; ECG scores; STEMI