2009 and STEMI - Cardiovascular Update

Anterior-wall and non-anterior-wall STEMIs do not differ in long-term mortality: results from the augsburg myocardial infarction registry

Frontiers in Cardiovascular Medicine

JANUARY 7, 2024

Background Different ST-segment elevation myocardial infarction (STEMI) localizations go along with dissimilarities in the size of the affected myocardium, the causing coronary vessel occlusion, and the right ventricular participation. Results Of the 2,195 patients, 1,118 had an anterior (AWS)- and 1,077 a non-anterior-wall-STEMI (NAWS).

Myocardial Infarction

Myocardial Infarction STEMI

What makes a T-wave Hyperacute? And: 30 Examples of Hyperacute T-waves, 10 in each of 3 myocardial territories.

Dr. Smith's ECG Blog

NOVEMBER 27, 2024

Doing so literally enables those of us who embrace the OMI Paradigm the ability to recognize within seconds that a patient with new CP ( C hest P ain ) — and — one or more hyperacute T waves — needs prompt cath regardless of potential absence of STEMI criteria. In Figure-1 is the ECG from the August 26, 2009 post in Dr. .:

Blog

Blog STEMI Research Outcomes

Septal STEMI with ST elevation in V1 and V4R, and reciprocal ST depression in V5, V6

Dr. Smith's ECG Blog

MARCH 13, 2013

You can see how V1, V2, aVR, and V4R would have ST elevation in either a right ventricular STEMI or with a septal STEMI, and how lateral leads, and even posterior leads, would have reciprocal ST depression. of patients with anterior STEMI, ST elevation of greater than or equal to 3.0 STE in V4R is confirmatory evidence.

STEMI

STEMI Myocardial Infarction Electrocardiogram Chest Pain

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Dr. Smith's ECG Blog

JULY 18, 2014

Thus, this is BOTH an anterior and inferior STEMI in the setting of RBBB. How old is this antero-inferior STEMI? Although acute anterior STEMI frequently has narrow QR-waves within one hour of onset (1. the presence of such well developed, wide, anterior Q-wave suggests completed transmural STEMI. Apr 28, 2009.

STEMI

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock

Which patient has the more severe chest pain?

Dr. Smith's ECG Blog

SEPTEMBER 26, 2023

Methods and Results Patients with confirmed ST elevation myocardial infarction (STEMI) treated by emergency medical services were included in this retrospective cohort analysis of the AVOID study. Greater severity of chest pain is presumed to be associated with a stronger likelihood of a true positive STEMI diagnosis. years old ± 13.7

Chest Pain

Chest Pain STEMI Myocardial Infarction Hospital

STEMI Breakthrough: Looking beyond Primary PCI with “Intra-coronary liquid oxygen”

Dr. S. Venkatesan MD

NOVEMBER 25, 2023

” R outine nasal Oxygen has little use in the management of STEMI. tried this in 2009 itself.(Ref 2009 Oct;2(5):366-75. It is tough to consider oxygen as a “powerful and magical drug”, because it is freely available everywhere.” In fact, it can be harmful as it causes vasoconstriction. Stone et al.

STEMI

STEMI Myocardial Infarction Download Document

Trends in the incidence, mortality and clinical outcomes in patients with ventricular septal rupture following an ST-elevation myocardial infarction

Coronary Artery Disease Journal

JUNE 10, 2024

Background Despite improvements in outcomes of ST elevation myocardial infarction (STEMI), ventricular septal rupture (VSR) remains a known complication, carrying high mortality. The contemporary incidence, mortality, and management of post-STEMI VSR remains unclear. In-hospital mortality was 73.6 ± 1.8%, but only 29.2 ± 1.9

Myocardial Infarction

Myocardial Infarction STEMI Outcomes Inpatient

How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Dr. Smith's ECG Blog

OCTOBER 8, 2024

Subtle as a STEMI." (i.e., Here is the bottom line of the article: It is widely believed that hyperacute T-waves are a transitional state preceding ST Elevation 1–4 Thus, it is tempting to postulate that early cases of OMI will eventually evolve to STEMI; yet, our data contradicts that notion. 2009;Available from: [link] 4.

Cardiac Arrest

Cardiac Arrest Myocardial Infarction STEMI Cardiogenic Shock

Precordial ST depression. What is the diagnosis?

Dr. Smith's ECG Blog

JANUARY 1, 2013

Precordial ST depression may be subendocardial ischemia or posterior STEMI. If you thought it might be a posterior STEMI, then you might have ordered a posterior ECG [change leads V4-V6 around to the back (V7-V9)]. So there was 3-vessel disease, but with an acute posterior STEMI. Blackwell Publishing 2009.

STEMI

STEMI Ischemia Chest Pain Myocardial Infarction

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

JANUARY 1, 2024

As per Dr. Aslanger — a number of medical providers were initial confused by what initially appears as marked ST elevation with reciprocal ST depression, indicative of an acute STEMI. That was also my initial concern. No "baseline" ECG is available for comparison.

Tachycardia

Tachycardia Blog Ischemia Heart Failure

From The Vault: RBBB

EMS 12-Lead

JULY 21, 2022

Original publication date July, 2009. Generally speaking, right bundle branch block does not mimic, or obscure, the ECG diagnosis of acute STEMI the way left bundle branch block does. This 12-lead ECG shows acute anterior STEMI in the presence of right bundle branch block, but you really need a trained eye to see it.

Bradycardia

Bradycardia Tachycardia STEMI Chest Pain

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Clinical Course The paramedic activated a “Code STEMI” alert and transported the patient nearly 50 miles to the closest tertiary medical center. 2 The astute paramedic recognized this possibility and announced a CODE STEMI. NEJM 362(9):779; March 4, 2009. NEJM 362(9):779; March 4, 2009. Look at the aortic outflow tract.

Ischemia

Ischemia Cardiogenic Shock Aortic Stenosis

Target Acquired

EMS 12-Lead

APRIL 2, 2022

Figure 1-1 My colleague, a faithful student of ECG interpretation, handed me the tracing and said that it warranted STEMI activation because of apparent terminal QRS distortion (TQRSD) in V2. ASA 324mg was administered while a STEMI activation was simultaneously transmitted to the nearest PCI center. Attached is the first ECG.

Myocardial Infarction

Myocardial Infarction Stent Stents STEMI

75 year old with 24 hours of chest pain, STEMI negative

Dr. Smith's ECG Blog

JUNE 8, 2023

STEMI negative : the EMS automated interpretation read, “STEMI negative. According to the STEMI paradigm, the patient doesn’t have an acute coronary occlusion and doesn't need emergent reperfusion, so the paramedics can bring them to the ED for assessment, without involving cardiologists. Inferior infarct, age undetermined.

Chest Pain

Chest Pain STEMI Bradycardia Myocardial Infarction

Anterior-wall and non-anterior-wall STEMIs do not differ in long-term mortality: results from the augsburg myocardial infarction registry

What makes a T-wave Hyperacute? And: 30 Examples of Hyperacute T-waves, 10 in each of 3 myocardial territories.

Septal STEMI with ST elevation in V1 and V4R, and reciprocal ST depression in V5, V6

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Which patient has the more severe chest pain?

STEMI Breakthrough: Looking beyond Primary PCI with “Intra-coronary liquid oxygen”

Trends in the incidence, mortality and clinical outcomes in patients with ventricular septal rupture following an ST-elevation myocardial infarction

How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Precordial ST depression. What is the diagnosis?

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

From The Vault: RBBB

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Target Acquired

75 year old with 24 hours of chest pain, STEMI negative

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