Dr. Smith's ECG Blog

MAY 5, 2024

He interprets here: "This EKG is diagnostic of right bundle branch block and transmural ischemia of the anterior wall, most likely from an occlusion of the proximal LAD. There was a 100% proximal LAD occlusion that was opened and stented. By the summer of 2012, he could read an ECG for OMI better than any doctor I knew.

EKG Technician 124

EKG Technician Chest Pain Blog STEMI 124

Dr. Smith's ECG Blog

OCTOBER 8, 2023

The patient was referred immediately for cath which revealed RCA occlusion that was stented. Remember, in diffuse subendocardial ischemia with widespread ST-depression there may b e ST-E in lead s aVR and V1. There are well formed R-waves with good voltage/amplitude which is uncommon for ischemia. There is ST depression in V1.

Ischemia 123

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 123

Dr. Smith's ECG Blog

DECEMBER 27, 2023

The pain will resolve and you will think the ischemia is gone when it is only hidden ! Just before 10 AM, the patient received a stent to the culprit OM. We know that today's patient has had prior inferior OMI with stenting of his proximal RCA ~3 years earlier. Peak troponin was 12 ng/mL. Tikkanen, J. Wellens, H., &

Chest Pain 131

Chest Pain Myocardial Infarction Blog Stent 131

EMS 12-Lead

JUNE 20, 2022

He was rushed to the Cath Lab where an LAD culprit lesion was stented. Here is the LAD after stent placement. It’s important to stress the presence of a normal QRS (i.e., This first image shows turbulent flow through stenotic narrowing of the vessel. With deliberate practice, spot diagnosis of T-to-R ratio will come with time.

STEMI 52

STEMI Stent Stents Myocardial Infarction 52

Dr. Smith's ECG Blog

MAY 8, 2023

Annals of Emergency Medicine 2012; 60(12):766-776. So the patient was taken for emergent cath, showing: Culprit artery: LAD (100% stenosis, TIMI 0) requiring thrombectomy and stent. EKG shown here: LAFB with no clear signs of OMI or ischemia. Queen of Hearts interpretation: Now the cardiologist considered it "STEMI"!

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Pacemaker 52

Dr. Smith's ECG Blog

MARCH 8, 2025

After stent deployment, we often see improvement in the ST-T within seconds or minutes. Here is the final angiogram following placement of a stent in the ostial RCA. 2:04 PM, post stent deployment You can see that even after complete restoration of flow, the ECG still looks terrible, V most of all. link] Mostofsky, E.,

Cardiomyopathy 75

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 75