The differential diagnosis of STEMI should also be taken into account

Strategies to mitigate delay in door-to-balloon(DTB) time [ [1] Ma J.-N. Wu X. Shen L.-J. Hu S.-Y. Chang Q. Xu Q. Type 1 myocardial infarction rapid screening scale for emergency triage in patients with non-traumatic chest pain: a study of 1928 cases with coronary angiography. Int. J. Cardiol. Epub. 2020; (ahead of print) Abstract Full Text Full Text PDF Scopus (1) Google Scholar ] should take into account the fact that the differential diagnosis of ST-elevation myocardial infarction(STEMI) includes pulmonary embolism(PE), PE-related paradoxical coronary embolism [ [2] Jolobe O.M.P. High prevalence of inferior ST segment elevation in pulmonary embolism-related paradoxical embolism. QJ Med. Article. 2020; (in press)https://doi.org/10.1093/qjmed/hcaa245 Crossref Google Scholar ], dissecting aneurysm of the aorta(DAA) [ [3] Abrams E. Allen A. Lahham S. Aortic dissection with subsequent hemorrhagic tamponade diagnosed with point-of-care ultrasound in a patient presenting with STEMI. Clin. Pract. Cases Emerg. Med. 2019; III: 103-106 Crossref Google Scholar ], and spontaneous tension pneumothorax, the latter either co-existing with STEMI [ [4] Mwamura P. Pasupati S. Swarbrick M. Lin R. Fisher R. Dual life-threatening pathologies presenting simultaneously. BMJ Case Reports. 2009; https://doi.org/10.1136/bcr.01.2009.1491:10.1136/bcr.01.2009.1491 Crossref Google Scholar ], or being the sole and reversible cause of ST segment elevation. Accordingly, the “quickly screening method for high-risk Type 1 MI patients” [ [1] Ma J.-N. Wu X. Shen L.-J. Hu S.-Y. Chang Q. Xu Q. Type 1 myocardial infarction rapid screening scale for emergency triage in patients with non-traumatic chest pain: a study of 1928 cases with coronary angiography. Int. J. Cardiol. Epub. 2020; (ahead of print) Abstract Full Text Full Text PDF Scopus (1) Google Scholar ] should include point-of-care TTE and ultrasound to optimise identification of the 4 STEMI-like subtypes [ 2 Jolobe O.M.P. High prevalence of inferior ST segment elevation in pulmonary embolism-related paradoxical embolism. QJ Med. Article. 2020; (in press)https://doi.org/10.1093/qjmed/hcaa245 Crossref Google Scholar , 3 Abrams E. Allen A. Lahham S. Aortic dissection with subsequent hemorrhagic tamponade diagnosed with point-of-care ultrasound in a patient presenting with STEMI. Clin. Pract. Cases Emerg. Med. 2019; III: 103-106 Crossref Google Scholar , 4 Mwamura P. Pasupati S. Swarbrick M. Lin R. Fisher R. Dual life-threatening pathologies presenting simultaneously. BMJ Case Reports. 2009; https://doi.org/10.1136/bcr.01.2009.1491:10.1136/bcr.01.2009.1491 Crossref Google Scholar ].