2020 Coronary Angiogram STEMI 
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
Post cath ECG: Now there are hyperacute T-waves again, and recurrent ST depression in V2 This ECG would normally diagnostic of OMI until proven otherwise No further troponins were measured, but it looks like there is recurrent OMI Next day: A CT Coronary Angiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. IMPRESSION: 1.
Ken Grauer, MD
JULY 15, 2023
CT coronary angiogram — No obstructive coronary disease. CT coronary angiogram showed no obstructive coronary disease. But immediate resolution of chest pain once VT was converted — and — the normal CT coronary angiogram — essentially ruled out acute coronary disease as the cause.
Dr. Smith's ECG Blog
JUNE 20, 2020
The medics were worried about STEMI, as it meets STEMI criteria. Discussion Thus, no further ECGs were recorded and there was no angiogram or stress test or CT coronary angiogram. The troponins are NOT consistent with STEMI (OMI), which typically has a troponin I of at least 5 ng/mL. What do you think?
Dr. Smith's ECG Blog
JANUARY 9, 2023
50% of LAD STEMIs do not have reciprocal findings in inferior leads, and many LAD OMIs instead have STE and/or HATWs in inferior leads instead. The ECG easily meets STEMI criteria in all leads V2-V6, as well. 24 yo woman with chest pain: Is this STEMI? This is not "diffuse", this is simply anterior, lateral, and likely apical.
Dr. Smith's ECG Blog
MAY 19, 2022
Ct coronary angiogram showed normal coronary arteries. Smith note: I think CT coronary angiogram is reasonable with the elevated troponins and symptoms. Anterior STEMI? He was given aspirin and heparin and transferred to the local cardiac center for further evaluation. What is it? Activate the Cath Lab?
EMS 12-Lead
APRIL 21, 2022
STEMI was activated and the patient went to Cath on arrival. It’s judicious, then, to arrange for coronary angiogram. Coronary occlusion, however, might be present concurrently with subendocardial ischemia on the time-zero ECG, or evolve into such. Does the ECG normalize? Canadian Journal of Cardiology, 34 ; 132-145. [2]
Dr. Smith's ECG Blog
MARCH 9, 2025
At 1210, the case was discussed with a cardiologist at a PCI capable facility, who accepted the patient for transfer, noting the ST depression in anterior leads as consistent with ischemia but not a STEMI. As shown in the mirror-image RED insert Isn't it now obvious that there is acute coronary occlusion causing isolated posterior OMI?
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