2015 Chest Pain STEMI 
Dr. Smith's ECG Blog
SEPTEMBER 29, 2023
Sent by anonymous, written by Pendell Meyers, reviewed by Smith and Grauer A man in his 40s presented to the ED with HTN, DM, and smoking history for evaluation of acute chest pain. He was eating lunch when he had sudden onset chest pressure, 9/10, radiating to his back, with sweating and numbness in both hands.
Dr. Smith's ECG Blog
MARCH 9, 2023
Sent by anonymous, written by Pendell Meyers A man in his 50s with no prior known medical history presented to the Emergency Department with severe intermittent chest pain. He denied any lightheadedness, shortness of breath, vomiting, or abdominal pain. Barely any STE, and thus not meeting STEMI criteria.
Dr. Smith's ECG Blog
MAY 8, 2023
Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. Code STEMI was activated by the ED physician based on the diagnostic ECG for LAD OMI in ventricular paced rhythm. Theiling BJ.
Dr. Smith's ECG Blog
AUGUST 3, 2017
A 70-year-old man calls 911 after experiencing sudden, severe chest pain. The precordial ST-depression pattern on this ECG (and in this clinical setting) should immediately raise suspicion of Posterior STEMI! But if there is none - then you are looking at least at an Isolated Posterior STEMI until proven otherwise.
Ken Grauer, MD
JUNE 14, 2024
Prompt cath is therefore advised if the post-ROSC shows an acute STEMI. The cause of the abnormal baseline deflections seen in Figure-2 is most likely muscle tremor artifact ( See Bouthillet T — ACLS Med Training, Dec, 2015 ). To Emphasize: The phenomenon of T-QRS-D is not needed in today's case to recognize the acute STEMI.
Dr. Smith's ECG Blog
NOVEMBER 28, 2018
A 50-something presented with epigastric and chest pain. Saddleback ST Elevation is almost never STEMI 2. Here are other cases of saddleback STE: Is this Saddleback a STEMI?? For M ore on B rugada E CG P atterns : Dr. Smith’s March 26, 2015 post has great illustrations reviewing assessment for a Brugada-2 ECG pattern.
Ken Grauer, MD
FEBRUARY 3, 2024
Despite the absence of significant coronary stenosis on her post-arrest cath — the ECG in Figure-1 is clearly diagnostic of an extensive anterolateral STEMI ( presumably from acute LAD [ L eft A nterior D escending ] coronary artery occlusion). The rhythm in ECG #1 is regular and supraventricular at a rate of ~75/minute. What is M INOCA?
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