Dr. Smith's ECG Blog

JUNE 18, 2013

His ECG was repeated at this point: This shows a well developed anterior STEMI. To not see these findings is very common, and this patient would be given the diagnosis of NonSTEMI, with subsequent development of STEMI. It is not a missed STEMI, but it is a missed coronary occlusion. The peak troponin I was over 100.

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STEMI Chest Pain Myocardial Infarction Webinar 52

Dr. Smith's ECG Blog

JANUARY 2, 2016

LVH and the diagnosis of STEMI - how should we apply the current guidelines? Journal of Electrocardiology 47 (2014) 655–660. This one mimics inferior STEMI (Figure 4): Concentric LVH, NO wall motion abnormality Case 5. How about diagnosing anterior STEMI in the setting of LVH? All troponins were negative.

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Ischemia Chest Pain STEMI Myocardial Infarction 52

Dr. Smith's ECG Blog

MARCH 6, 2019

This is technically a STEMI, with 1.5 However, I think many practitioners might not see this as a clear STEMI, and would instead call this "borderline." They collected several repeat ECGs at the outside hospital before transport: None of these three ECGs meet STEMI criteria. This ECG was recorded on arrival: What do you think?

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STEMI Chest Pain Ischemia Myocardial Infarction 52

Dr. Smith's ECG Blog

OCTOBER 13, 2022

But it doesn’t meet STEMI criteria, and was not identified by the computer or the over-reading cardiologist. Still no WPW pattern, and more obvious inferoposterior OMI, but still STEMI negative. The emergency physician wasn’t sure what to make of the changes from one ECG to the next but was concerned about ACS. What do you think?

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Chest Pain Myocardial Infarction Ischemia STEMI 52

Dr. Smith's ECG Blog

DECEMBER 14, 2016

ng/mL (ULN = 0.030 ng/mL) , diagnostic of myocardial injury. The "criteria" for posterior STEMI are 0.5 Acute myocardial injury: Is it myocardial infarction, or perhaps myocarditis? Is it STEMI or NonSTEMI? This is from the 2014 ACC/AHA guidelines. The troponin I returned at 4.1 mm STE in one lead.

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Chest Pain STEMI Aortic Pulmonary 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. aVR ST segment elevation: acute STEMI or not? aVR ST Segment Elevation: Acute STEMI or Not?

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Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

APRIL 22, 2022

The HEART and EDACS scores are helpful to risk stratify patients with chest pain, but they hinge on accurate ECG interpretation: a low score doesn’t apply if the ECG shows STEMI(+)OMI, and shouldn’t be used for STEMI(-)OMI or OMI reperfusion either 2. Case Rep Emerg Med 2014 7. Lancet 2015 6. Patel J, Alattar F, Koneru J, et al.

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Chest Pain Ischemia Myocardial Infarction Angina 52

Dr. Smith's ECG Blog

SEPTEMBER 21, 2022

V5-V6) of any amplitude, is specific for Occlusion Myocardial Infarction (vs. OMI that are not STEMI can be very subtle and difficult to diagnose even though the findings are very specific. Posterior infarctions often ( though not always ) result in an increase in R wave amplitude in anterior leads.

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Chest Pain Blog Ischemia STEMI 52

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. myocardial infarction), arrhythmias, valvular pathology, shunts, or outflow obstructions.

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Ischemia Cardiogenic Shock Aortic Stenosis 40

Dr. Smith's ECG Blog

MARCH 11, 2019

Here is data from a study we published in 2014 for type II NonSTEMI: Sandoval Y. Cardiac Troponin Changes to Distinguish Type 1 and Type 2 Myocardial Infarction and 180-Day Mortality Risk. First was 2.9 ng/mL and subsequentle dropped to 1.5 ng/mL Such high troponin I is very unusual in type 2 MI. Murakami M.

Chest Pain 52

Chest Pain Ischemia Aneurysm Myocardial Infarction 52

Dr. Smith's ECG Blog

JULY 19, 2024

It was read by the treating physician and the overreading cardiologist as "Paced, no STEMI." of very high risk NSTEMI patients underwent angiography in less than 2 hours in accordance with the 2014 ACC/AHA guidelines. Diagnosis of Occlusion Myocardial Infarction in Patients with Left Bundle Branch Block and Paced Rhythms.

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Chest Pain Myocardial Infarction Pacemaker STEMI 115

Frontiers in Cardiovascular Medicine

DECEMBER 18, 2024

BackgroundAcute myocardial infarction (AMI), particularly ST-segment elevation myocardial infarction (STEMI), significantly impacts global health, exacerbated by risk factors such as diabetes mellitus (DM).

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STEMI Myocardial Infarction Risk Factors Diabetes 52

Dr. Smith's ECG Blog

DECEMBER 16, 2024

She had this ECG recorded: Obvious massive anterior STEMI She was quickly brought to the critical care area and the cath lab was activated. Here is the ECG at 25 minutes: Terrible LAD STEMI (+) OMI So a CT scan was done which of course showed a normal aorta. This time the Queen of Hearts interpreted: No STEMI or Equivalent.

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Chest Pain Aortic STEMI Ultrasound 105

Dr. Smith's ECG Blog

MARCH 8, 2025

The authors describe a case with some features in common with our patient -- a stressful event followed by a stress cardiomyopathy/acute myocardial infarction overlap syndrome. Acute myocardial infarction: an uncommon complication of takotsubo cardiomyopathy. Acute myocardial infarction triggered by emotional stress.

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Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 75