Dr. Smith's ECG Blog

JULY 21, 2024

The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. In this study — Procainamide was superior to Amiodarone for terminating monomorphic VT, as well as having fewer adverse effects than Amiodarone ( Ortiz et al — Eur Heart J 1;38 (17): 1329-1335, 2017 ). The below ECG was recorded.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

JULY 22, 2023

A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. So maybe she is better than I am.

Chest Pain 92

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 92

Dr. Smith's ECG Blog

JANUARY 30, 2019

2) The STE in V1 and V2 has an R'-wave and downsloping ST segments, very atypical for STEMI. Cardiology was consulted and they agreed that the EKG had an atypical morphology for STEMI and did not activate the cath lab. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Bicarb 20, Lactate 4.2,

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

JANUARY 21, 2023

ECG met STEMI criteria and was labeled STEMI by computer interpretation. J waves can also be induced by Occlusion MI (5), STEMI mimics including takotsubo and myocarditis complicated by ventricular arrhythmias (6, 7), and subarachnoid hemorrhage with VF (8). Take home : Not all STEs are STEMIs or OMIs. What do you think?

STEMI 52

STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Dr. Smith's ECG Blog

DECEMBER 5, 2019

Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep. This is based on the Sieira et al, 2017, risk calculator , which gives a borderline risk score (2). Syncope and ST Segment Elevation. And another finding.

Sudden Cardiac Death 52

Sudden Cardiac Death Heart Rhythm Article Tachycardia 52

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

A 12-lead was recorded, showing "STEMI," but is unavailable. The patient was unconscious BEFORE the cardiac arrest, at the same time that she had strong pulses. Therefore, cardiac arrest is NOT the etiology of the coma. She was BVM ventilated and suctioned. Shortly thereafter, pulses were lost.

STEMI 89

STEMI Hemorrhage Cardiac Arrest Tachycardia 89

Dr. Smith's ECG Blog

FEBRUARY 10, 2025

2] Curiously, ACLS does not include consideration of calcium in its bradycardia algorithm, which could have prevented the arrest and which along with the epi produced ROSC. HyperKalemia with Cardiac Arrest. West J Emerg Med 2017. regardless of the ECG (when the repeat level came back).[1] References 1. Lindner et al.

Bradycardia 118

Bradycardia Cardiac Arrest Hypertension ICU 118