Dr. Smith's ECG Blog

JANUARY 20, 2017

Validation of the Modified Sgarbossa Rule for Diagnosis of STEMI in the Presence of Left Bundle Branch Block. American Heart Journal 170(6):1255-1264; December 2015. Theiling BJ. 0 0 1 41 238 MMRF 1 1 278 14.0 So there is a definite inferior and lateral MI. Here is the first ECG recorded after reperfusion: ST deviation has resolved.

STEMI 52

STEMI Chest Pain Stent Stents 52

Dr. Smith's ECG Blog

MAY 8, 2023

Code STEMI was activated by the ED physician based on the diagnostic ECG for LAD OMI in ventricular paced rhythm. This was several months after the 2022 ACC Guidelines adding modified Sgarbossa criteria as a STEMI equivalent in ventricular paced rhythm). American Heart Journal 170(6):1255-1264; December 2015. Theiling BJ.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Pacemaker 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

Unfortunately, we do not have those images for review, but the operators described a ruptured LAD plaque and they stented this area, which ensures the stability of the plaque. The image on the left shows the LAD before intervention, and the red circled portion on the right indicates the stented region.

Plaque 127

Plaque Angina Blog Stent 127

EMS 12-Lead

MAY 20, 2022

This worried the crew of potential acute coronary syndrome and STEMI was activated pre-hospital. As it currently stands, an ST/S ratio >15% should raise awareness for new anterior STEMI. A mid-LAD culprit lesion was identified and stented. Smith comment : V5 and V6 are excessively discordant!!!! References Naidu, S.

Cardiomyopathy 52

Cardiomyopathy Ischemia STEMI Coronary Angiogram 52

EMS 12-Lead

APRIL 2, 2022

He reported a history of ischemic cardiomyopathy with coronary stent placement approximately 10 years prior, but could not recall the specific artery involved. ASA 324mg was administered while a STEMI activation was simultaneously transmitted to the nearest PCI center. A 99% LAD occlusion was stented. Attached is the first ECG.

Myocardial Infarction 52

Myocardial Infarction Stent Stents STEMI 52

Dr. Smith's ECG Blog

SEPTEMBER 17, 2020

Dr. Smith illustrates how to measure these parameters with magnified views in his December 21, 2015 post. In the context of the abnormal ST elevation we see in leads III and aVF I interpreted this mirror-image J-point depression as a reciprocal change in this LBBB patient whose ECG is diagnostic of an acute inferior STEMI.

Chest Pain 52

Chest Pain STEMI Blog Myocardial Infarction 52

Dr. Smith's ECG Blog

MAY 23, 2022

Note: according to the STEMI paradigm these ECGs are easy, but in reality they are difficult. Theres inferior STE which meets STEMI criteria, but this is in the context of tall R waves (18mm) and relatively small T waves, and the STD/TWI in aVL is concordant to the negative QRS. This was false positive STEMI with an ECG mimicking OMI.

Chest Pain 52

Chest Pain Pericarditis STEMI Arrhythmia 52