2019 Echocardiogram STEMI 
Dr. Smith's ECG Blog
MAY 13, 2020
What do you think the echocardiogram shows? There is a subtle but important difference between OMI and subendocardial ischemia: OMI (that is not STEMI) is due to TIMI 0/1 flow and has any combination of subtle STE, hyperacute T-waves, reciprocal ST depression, decreased QRS amplitude, terminal QRS distortion and other findings.
Dr. Smith's ECG Blog
OCTOBER 15, 2024
A prehospital “STEMI” activation was called on a 75 year old male ( Patient 1 ) with a history of hyperlipidemia and LAD and Cx OMI with stent placement. Additionally, a bedside echocardiogram showed no wall motion abnormality and normal LV function. He wrote most of it and I (Smith) edited.
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). Echocardiogram was obtained and showed mild LVH without regional wall motion abnormality.
Dr. Smith's ECG Blog
DECEMBER 19, 2023
His echocardiogram showed normal wall motion. From My Comment in the November 14, 2019 post in Dr. Smith's ECG Blog: A subject well worth periodic review — is the concept of Terminal QRS Distortion ( T-QRS-D ). Figure-4: I've labeled the first 2 ECGs shown in the November 14, 2019 post ( See text ).
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. See this case: what do you think the echocardiogram shows in this case?
Dr. Smith's ECG Blog
JANUARY 1, 2024
A rapid echocardiogram was performed, revealing an ejection fraction of 20% with thinning of the anterior-apical walls. As per Dr. Aslanger — a number of medical providers were initial confused by what initially appears as marked ST elevation with reciprocal ST depression, indicative of an acute STEMI. That was also my initial concern.
Dr. Smith's ECG Blog
AUGUST 6, 2024
Elevated troponins prompted an echocardiogram — which revealed an apical wall motion abnormality (WMA). It definitely does not fulfill STEMI criteria, and I would argue that it would not lead to cath lab activation in most centers. Patient #1 in today's post did not get expert ECG interpretation. The ECG shows ST depression in lead V3.
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