2021 STEMI Stent 
Dr. Smith's ECG Blog
OCTOBER 1, 2023
This is a re-post of an excellent case from 2021. A man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. Here is the EM decision making: "The patient's EKG revealed some repolarization abnormalities but no clear signs of a STEMI.
Frontiers in Cardiovascular Medicine
MARCH 10, 2024
Background Hyperglycemia, characterized by elevated blood glucose levels, is frequently observed in patients with acute coronary syndrome, including ST-elevation myocardial infarction (STEMI). There are conflicting sources regarding the relationship between hyperglycemia and outcomes in STEMI patients. 3.45) and 4.47 (95% CI: 2.54–7.87),
Dr. Smith's ECG Blog
MAY 23, 2023
Notice on the right side of the image how the algorithm correctly measures STE sufficient in V1 and V2 to meet STEMI criteria in a man older than age 40. As most would agree, this ECG shows highly specific findings of anterolateral OMI, even with STEMI criteria in this case. Thus, this is obvious STEMI(+) OMI until proven otherwise.
Dr. Smith's ECG Blog
JANUARY 3, 2022
Step 1 to missing posterior MI is relying on the STEMI criteria. A prospective validation of STEMI criteria based on the first ED ECG found it was only 21% sensitive for Occlusion MI, and disproportionately missed inferoposterior OMI.[1] But it is still STEMI negative. A 15 lead ECG was done (below). In a study last year, 14.4%
Dr. Smith's ECG Blog
MAY 30, 2023
There is an obvious inferior posterior STEMI(+) OMI. Angiogram: Culprit Lesion (s): Thrombotic occlusion of the proximal RCA -- stented. Results Of 149 patients with inferior STEMI , 43 (29%) had RVMI and 106 (71%) did not. What is the atrial activity? Is it sinus arrest with junctional escape? How would one tell?
Dr. Smith's ECG Blog
NOVEMBER 22, 2023
20% of cases that everyone would call a STEMI have a competely open artery by the time of angiogram 60-90 minutes later. Previously placed stents in the LAD (multiple) and mid circumflex and patent Formal echocardiogram: Normal left ventricular size and wall thickness.
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.
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