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 Wong, 2012) STE in aVR of at least 0.5
Dr. Smith's ECG Blog
MAY 5, 2024
Pendell Meyers had not started medical school by summer of 2012, but he had read every one of my blog posts over the preceding 4 years. By the summer of 2012, he could read an ECG for OMI better than any doctor I knew. Such proficient interpreters include health care assistants and EKG technicians. He was a paramedic at the time.
Dr. Smith's ECG Blog
JUNE 1, 2012
Though the ST Elevation does not meet STEMI criteria, it is an obvious OMI. In LVH, just like in BBB, the ST segment (and T-waves) are often discordant to the majority of the QRS (ST elevated if QRS negative, as in inferior leads, or depressed if QRS mostly positive, as in I and aVL).
Dr. Smith's ECG Blog
JANUARY 2, 2016
LVH and the diagnosis of STEMI - how should we apply the current guidelines? This one mimics inferior STEMI (Figure 4): Concentric LVH, NO wall motion abnormality Case 5. Contrast the above with this one, which has both LVH and inferior STEMI : There is limb lead LVH with superimposed inferior STEMI. They are quite rare.
Dr. Smith's ECG Blog
AUGUST 3, 2017
The precordial ST-depression pattern on this ECG (and in this clinical setting) should immediately raise suspicion of Posterior STEMI! Posterior STEMI occurs in approximately 15-20% of acute MI, but the vast majority of the time it is seen in conjunction with inferior (Infero-Posterior) or lateral (Postero-Lateral) STEMI (1).
Dr. Smith's ECG Blog
MAY 23, 2014
However, there are also Q-waves inferiorly and the inferior T-waves are inverted, suggesting that this is an old MI with persistent ST elevation, or, alternatively, a subacute or partially reperfused, inferior STEMI. This is all but diagnostic of inferior-posterior STEMI. There is ST depression in V4-V6.
Dr. Smith's ECG Blog
FEBRUARY 16, 2020
So Shark Fin really is just a dramatic representation of STEMI, and can be in any coronary distribution. So this is STEMI, right? 109 (20):361-368, 2012 — CLICK HERE ). It is often confused with a wide QRS due to conditions such as hyperkalemia. Which artery? There is ST Elevation in every lead except aVR (STD in aVR).
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