subtle_anterior_stemi_4_variable: Subtle Anterior STEMI Calculator (4-Variable)

In cliot: Clinical Indices and Outcomes Tools

Subtle Anterior STEMI Calculator (4-Variable)

Description

Calculates the 4-Variable score to differentiate between subtle anterior STEMI (LAD occlusion) and Early Repolarization in patients with chest pain and subtle ST-segment elevation. A score greater than or equal to 18.2 predicts STEMI with high sensitivity and specificity.

Usage

subtle_anterior_stemi_4_variable(qtc_ms, qrs_v2_mm, r_wave_v4_mm, ste_60_v3_mm)

Arguments

qtc_ms	Numeric. The computerized QTc interval in milliseconds.
qrs_v2_mm	Numeric. The total QRS amplitude in lead V2 in millimeters.
r_wave_v4_mm	Numeric. The R-wave amplitude in lead V4 in millimeters.
ste_60_v3_mm	Numeric. ST-segment elevation at 60 milliseconds after the J-point in lead V3, measured in millimeters.

Value

A list containing:

Score	The calculated 4-variable model score.
Interpretation	Prediction of "Likely Anterior STEMI" or "Likely Early Repolarization" based on the 18.2 cutoff.

References

Smith SW, Khalil A, Henry TD, et al. Electrocardiographic differentiation of early repolarization from subtle anterior ST-segment elevation myocardial infarction. Ann Emerg Med. 2012;60(1):45-56.e2. doi:10.1016/j.annemergmed.2012.02.015

Examples

# Example 1: Likely Early Repolarization
# QTc 390ms, QRS V2 25mm, R-wave V4 15mm, STE60 V3 1.5mm
# Score = (0.052*390) - (0.151*25) - (0.268*15) + (1.062*1.5) = 14.08
subtle_anterior_stemi_4_variable(390, 25, 15, 1.5)

# Example 2: Likely Anterior STEMI
# QTc 420ms, QRS V2 10mm, R-wave V4 5mm, STE60 V3 3.0mm
# Score = (0.052*420) - (0.151*10) - (0.268*5) + (1.062*3.0) = 22.18
subtle_anterior_stemi_4_variable(420, 10, 5, 3.0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.