2017, Myocardial Infarction and STEMI

Anterior-wall and non-anterior-wall STEMIs do not differ in long-term mortality: results from the augsburg myocardial infarction registry

Frontiers in Cardiovascular Medicine

JANUARY 7, 2024

Background Different ST-segment elevation myocardial infarction (STEMI) localizations go along with dissimilarities in the size of the affected myocardium, the causing coronary vessel occlusion, and the right ventricular participation. No significant associations of the STEMI localization with long-term mortality were found.

Myocardial Infarction

Myocardial Infarction STEMI

Peak troponin T in STEMI: a predictor of all-cause mortality and left ventricular function

Open Heart

MAY 23, 2022

Background The clinical significance of peak troponin levels following ST-elevation myocardial infarction (STEMI) has not been definitively established. Methods A single-centre retrospective observational study was conducted of all patients with STEMI between January 2015 and December 2017. The mean age was 63.6±12

STEMI

STEMI Myocardial Infarction

How unreliable are computer algorithms in the Diagnosis of STEMI?

Dr. Smith's ECG Blog

MARCH 10, 2017

Acad Emerg Med 2017; 24(1): 120 – 24. The cath lab was activated, as it should be with transient STEMI. See this case of transient STEMI: Spontaneous Reperfusion and Re-occlusion - My Bad Thinking Contributes to a Death. It is not yet available, but this is your way to get on the list. link] Hughes KE et al.

STEMI

STEMI Chest Pain Myocardial Infarction Electrocardiogram

Unconscious + STEMI criteria: activate the cath lab?

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

STEMI Bradycardia Arrhythmia Cardiac Arrest

An elderly male with acute altered mental status and huge ST Elevation

Dr. Smith's ECG Blog

OCTOBER 12, 2024

Written by Bobby Nicholson What do you think of this “STEMI”? Second, although there is a lot of ST Elevation which meets STEMI criteria, especially in V3-4, the ST segment is extremely upwardly concave with very large J-waves (J-point notching). 2017 Sep-Oct;50(5):561-569. Epub 2017 Apr 19. There is high QRS voltage.

STEMI

STEMI Document Blog Ischemia

Abstract 4141279: Catch me if you flow slow: The temporal filter slow flow fact

Circulation

NOVEMBER 11, 2024

Methods:STEMI patients who underwent coronary revascularization therapy and cardiac magnetic resonance (CMR) at about 4 days and 6 months between 2017 and 2023 were included. The patients were divided into groups (Group 1, FSF (-) during procedures with final TIMI-3; Group 2, FSF (+) with TIMI-3; Group 3, final angiogram was non-TIMI-3).

Myocardial Infarction

Myocardial Infarction STEMI Kidney Disease Thrombolysis

Should Emergency Physicians be interrupted by ECGs that are read as "Normal" by the computer?

Dr. Smith's ECG Blog

JUNE 12, 2017

This is diagnostic of inferior MI, though does not meet millimeter criteria for "STEMI." He was worried for inferior MI and ordered another, which was recorded 15 minutes later: Now clearly and obviously diagnostic of inferior STEMI. January 2017. There is also ST elevation in lateral precordial leads V5 and V6.

Chest Pain

Chest Pain STEMI Myocardial Infarction Electrocardiogram

Should Troponin be a Vital Sign? Perhaps, but only if Interpreted Using Pre-test Probability.

Dr. Smith's ECG Blog

FEBRUARY 5, 2019

LAD 80% mid LCx occluded mid (acute infarct lesion) RCA 80% mid. PCI mid LCx So this is an OMI (Occlusion Myocardial Infarction), but not a STEMI Echo: Decreased left ventricular systolic performance, mild/moderate. Cardiac Troponin Changes to Distinguish Type 1 and Type 2 Myocardial Infarction and 180-Day Mortality Risk.

Myocardial Infarction

Myocardial Infarction Chest Pain Cardiogenic Shock STEMI

Occlusion/reperfusion through 6 ‘normal’ ECGs

Dr. Smith's ECG Blog

FEBRUARY 10, 2022

While this ECG is negative for “posterior STEMI”, the resolution of anterior ST depression (accompanied by the troponin elevation) confirms posterior OMI with spontaneous reperfusion. The second opportunity to make the diagnosis and expedite angiography was missed because the ECG never met STEMI criteria and continued to be labeled ‘normal.’

STEMI

STEMI Myocardial Infarction Chest Pain Angina

What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

JULY 21, 2024

The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. Troponin T peaked at 38,398 ng/L ( = a very large myocardial infarction, but not massive-- thanks to the pre-PCI spontaneous reperfusion, and rapid internvention!! ). The below ECG was recorded. Inotropic medication was continued.

Arrhythmia

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator

Anterior MI in paced rhythm, dismissed by cardiologist, patient died.

Dr. Smith's ECG Blog

OCTOBER 3, 2018

Details cannot be shared here, but suffice it to say that inability to recognize acute occlusive myocardial infarction in the presence of ventricular paced rhythm contributed to a poor outcome. Impact of total occlusion of culprit artery in acute non-ST elevation myocardial infarction: a systematic review and meta-analys is.

Chest Pain

Chest Pain Myocardial Infarction STEMI Ischemia

Hypertrophic Cardiomyopathy

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. New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department.

Cardiomyopathy

Cardiomyopathy Ischemia STEMI Coronary Angiogram

Formula Utilization

EMS 12-Lead

JUNE 20, 2022

A prehospital STEMI activation was transmitted to the closest PCI center, and 324mg ASA was administered. The attending crews were concerned for an ACS-equivalent of LAD occlusion and initiated a prehospital STEMI activation to the closest PCI center. As the conversation progressed, another ECG spontaneously printed. 2] Driver, B.

STEMI

STEMI Stents Stent Myocardial Infarction

12 Example Cases of Use of 3- and 4-variable formulas, plus Simplified Formula, to differentiate normal STE from subtle LAD occlusion

Dr. Smith's ECG Blog

NOVEMBER 3, 2017

Electrocardiographic Differentiation of Early Repolarization FromSubtle Anterior ST-Segment Elevation Myocardial Infarction. These kinds of cases were excluded from the study as obvious anterior STEMI. --QTc J Electrocardiology 50(5):561-569; September/October 2017. Annals of Emergency Medicine 2012;60:45-56.

Chest Pain

Chest Pain STEMI Bradycardia Stenosis

A young peripartum woman with Chest Pain

Dr. Smith's ECG Blog

OCTOBER 24, 2019

Angie Lobo ( @aloboMD ) (For open-access reviews of this literature, see Saw 2016 , Saw 2017 , or Hayes 2018.) A recent study found that SCAD causes almost 20% of STEMI in young women. examined SCAD presenting as STEMI (unlike Hassan et al. A study by Hassan et al. Lobo et al. where more than 3/4 of cases were NSTEMI).

Chest Pain

Chest Pain SCAD STEMI Cardiogenic Shock

Two patients with chest pain, with QRS obscured: which was STEMI positive, and which had Occlusion MI?

Dr. Smith's ECG Blog

JANUARY 17, 2024

The limb leads have been removed because there was no ST elevation in those leads, the QRS complexes have been obscured because this is irrelevant to STEMI criteria, and red lines have been added to measure ST segment elevation. But STEMI criteria ignore all this and look at ST segments in isolation.

Chest Pain

Chest Pain STEMI Myocardial Infarction Blog

Cardiovascular Update

Anterior-wall and non-anterior-wall STEMIs do not differ in long-term mortality: results from the augsburg myocardial infarction registry

Peak troponin T in STEMI: a predictor of all-cause mortality and left ventricular function

How unreliable are computer algorithms in the Diagnosis of STEMI?

Unconscious + STEMI criteria: activate the cath lab?

An elderly male with acute altered mental status and huge ST Elevation

Abstract 4141279: Catch me if you flow slow: The temporal filter slow flow fact

Should Emergency Physicians be interrupted by ECGs that are read as "Normal" by the computer?

Should Troponin be a Vital Sign? Perhaps, but only if Interpreted Using Pre-test Probability.

Occlusion/reperfusion through 6 ‘normal’ ECGs

What are treatment options for this rhythm, when all else fails?

Anterior MI in paced rhythm, dismissed by cardiologist, patient died.

Hypertrophic Cardiomyopathy

Formula Utilization

12 Example Cases of Use of 3- and 4-variable formulas, plus Simplified Formula, to differentiate normal STE from subtle LAD occlusion

A young peripartum woman with Chest Pain

Two patients with chest pain, with QRS obscured: which was STEMI positive, and which had Occlusion MI?

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