Rapid ECG interpretation after cardiac arrest (ROSC) saves lives. Keep it simple and practical:

🔑 ECG Red Flags:

Classic STEMI: ≥1 mm ST elevation in 2+ contiguous leads.
Posterior MI: ST depression in V1–V3.
LBBB/Paced Rhythm: Use Modified Sgarbossa criteria (concordant ST elevation/depression or discordant elevation ≥25% S-wave depth).
Left Main Equivalent: ST elevation aVR ≥ V1 plus diffuse depression in leads I, II, V4–V6.

⏳ Timing Tip:
ECGs done immediately post-ROSC (<7 min) often yield false positives.
Always repeat ECG after 8–10 min to confirm true ischemia.

✅ Simple Action Plan:

Persistent ST elevation at 10 min → Immediate cath lab activation.
ST changes resolved with perfusion → Consider alternate non-cardiac causes.

🚩 Clinical Pearl:

“Not every ST elevation post-ROSC means immediate cath—confirm before you act!”

How do you manage tricky post-ROSC ECG interpretations? I’d love to hear your experiences!