Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4142231-A4142231, November 12, 2024. Background:Little is known about the clinical relevance of interleukin (IL)-6 and the severity of patients with acute ST-elevation myocardial infarction (STEMI). All information about clinical and paraclinical parameters was recorded.

STEMI 40

STEMI Myocardial Infarction Tricuspid Biomarkers 40

Dr. Smith's ECG Blog

SEPTEMBER 5, 2024

This is a value typical for a large subacute MI, n ormal value 48 hours after myocardial infarction is associated with Post-Infarction Regional Pericarditis ( PIRP ). Mechanical complications secondary to myocardial infarction are infrequent due to most patients receiving revascularization quite rapidly.

Cardiogenic Shock 109

Cardiogenic Shock Chest Pain Pericarditis Myocardial Infarction 109

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

Here is his ED ECG at triage: Obvious high lateral OMI that does not quite meet STEMI criteria. Thus, it has recently become generally accepted that most plaque ruptures resulting in myocardial infarction occur in plaques that narrow the lumen diameter by 40% of the arterial cross section may be involved by plaque.

Ischemia 122

Ischemia Plaque Stenosis Myocardial Infarction 122

Nature Reviews - Cardiology

APRIL 1, 2024

Nature Reviews Cardiology, Published online: 02 April 2024; doi:10.1038/s41569-024-01020-2 In ST-segment elevation myocardial infarction, the role of interventional modification of thrombi in the coronary arteries before stenting is controversial.

STEMI 40

STEMI Myocardial Infarction Embolism Innovation 40

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4147134-A4147134, November 12, 2024. Introduction:Elevated LDL cholesterol is linked to microvascular injury and adverse cardiac events in STEMI patients. This study examines the impact of prior statin use on LDL levels at the time of MI, focusing on NSTEMI and STEMI patients.

STEMI 40

STEMI Cholesterol Myocardial Infarction Document 40

Dr. Smith's ECG Blog

APRIL 22, 2024

Patient still not having chest pain however this is more concerning for OMI/STEMI. Wellens' syndrome is a syndrome of Transient OMI (old terminology would be transient STEMI). A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty.

Chest Pain 118

Chest Pain Myocardial Infarction Anatomy Angina 118

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). With EMS, patient had a GCS of 3 and was saturating 60% on room air. ng/mL and 0.10

STEMI 116

STEMI Document Blog Ischemia 116

Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

Smith : there is some minimal ST elevation in V2-V6, but does not meet STEMI criteria. Transient STEMI has been studied and many of these patients will re-occlude in the middle of the night. Timing of revascularization in patients with transient ST segment elevation myocardial infarction: a randomized clinical trial.

Chest Pain 116

Chest Pain Myocardial Infarction STEMI Pericarditis 116

Dr. S. Venkatesan MD

SEPTEMBER 1, 2024

“ Since Intravenous lysis looks too simplistic, that do not need expertise, and lacks a commercial trail, it is wrongly depicted as inferior management strategy in STEMI “ Every one of us is equally responsible for this sorry state of affairs. In LAD STEMI time is more crucial. NRMI data Ref 2) 2.There

Thrombolysis 52

Thrombolysis Myocardial Infarction Academic STEMI 52

Dr. S. Venkatesan MD

APRIL 25, 2024

What we can do, at our level is to incorporate a new term “ benign or micro myocardial Infarction” – akin to lacunar infarcts or TIA equivalents of the brain in the heart. Is Myocardial Infarction Overdiagnosed? Published online April 24, 2024. Reference 1.McCarthy doi:10.1001/jama.2024.5235

Myocardial Infarction 52

Myocardial Infarction Article ICU Hospital 52

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4141279-A4141279, November 12, 2024. Background:Slow flow phenomenon is impaired coronary flow during percutaneous coronary intervention (PCI) in absence of mechanical obstruction, and it is associated with deteriorated outcome.

STEMI 40

STEMI Myocardial Infarction Kidney Disease Thrombolysis 40

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

The emergency physician asked the advice of Dr. Reiters because of absence of STEMI criteria. Translation from French: Acute Occlusion Myocardial Infarction with High Confidence. But if the pain is persistent, as reported, then the patient must go to the cath lab even if the ECG suggests reperfusion.

Hospital 85

Hospital STEMI Blog Chest Pain 85

The British Journal of Cardiology

APRIL 16, 2024

Clinical presentation was stable angina 130/567 (22.9%), non-ST-elevation acute coronary syndrome (NSTEACS) 312/567 (55%), ST-elevation myocardial infarction (STEMI) 125/567 (22.0%), and STEMI with cardiogenic shock 13/125 (10.4%). The radial approach was used in 544/567 (95.94%), the average SYNTAX score was 34.8 ± 9.6,

Outcomes 40

Outcomes Cardiogenic Shock Angina STEMI 40

Dr. Smith's ECG Blog

AUGUST 6, 2024

The ECG is diagnostic of occlusion myocardial infarction (OMI). It definitely does not fulfill STEMI criteria, and I would argue that it would not lead to cath lab activation in most centers. The overall read is OMI with HIGH confidence. == Below is the ECG of Patient #2 — as interpreted by the QOH.

Chest Pain 104

Chest Pain Ischemia Pericarditis Tachycardia 104

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

The ECG was read as "No STEMI" and the patient was treated like an average chest pain patient (despite the fact that a chest pain patient with active pain and active subendocardial ischemia is very high risk). The Queen of Hearts AI app will hopefully be FDA approved in Q1 of 2024. It is already approved in Europe. Eur J Emerg Med.

Chest Pain 83

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 83

Dr. Smith's ECG Blog

JANUARY 5, 2024

So there is probability of myocardial injury here (and because it is in the correct clinical setting, then myocardial infarction.) Sometimes it can take 12 or 24 hours to see ECG evidence of reperfusion. == MY Comment , by K EN G RAUER, MD ( 1/4/ 2024 ): == Superb and thorough discussion by Dr. Frick of today's case!

Angina 121

Angina Plaque Document Stents 121

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 118

Chest Pain STEMI Myocardial Infarction Blog 118

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4141170-A4141170, November 12, 2024. In cardiovascular research, serotonin has been implicated in modulating vascular tone, platelet aggregation, and myocardial function. Conclusion:Higher 5-HTP levels are independently associated with a reduced risk of MACE in patients after STEMI.

Myocardial Infarction 40

Myocardial Infarction Coronary Artery Bypass Graft STEMI Angina 40

Dr. Smith's ECG Blog

AUGUST 9, 2024

The receiving emergency physician consulted with interventional cardiology who stated there was no STEMI. AIVR is not always the result of significant pathology, but is classically associated with the reperfusion phase of acute myocardial infarction. Is there STEMI? The patient continued having chest pain. Moffat, M.

Chest Pain 107

Chest Pain Arrhythmia Myocardial Infarction STEMI 107

Journal of Cardiovascular Pharmacology

NOVEMBER 11, 2024

Patients with ST-segment elevation myocardial infarction (STEMI) and complex coronary artery disease (CAD) face a poor prognosis, including increased heart failure (HF) risk. We performed a pooled secondary analysis of 139 patients with STEMI. We performed a pooled secondary analysis of 139 patients with STEMI.

Coronary Artery Disease 40

Coronary Artery Disease Myocardial Infarction STEMI Heart Failure 40

Circulation: Cardiovascular Imaging

NOVEMBER 29, 2024

Circulation: Cardiovascular Imaging, Volume 17, Issue 12 , Page e017041, December 1, 2024. BACKGROUND:The presence and clinical significance of hepatic tissue alterations as assessed by cardiac magnetic resonance imaging in patients with ST-segmentelevation myocardial infarction (STEMI), are unclear.

Myocardial Infarction 40

Myocardial Infarction STEMI Cardiovascular Imaging Outcomes 40

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4132742-A4132742, November 12, 2024. A random-effects model was used for outcomes with high heterogeneity.Results:We included 4 RCTs with 3173 patients comparing FFR-guided CR with culprit-only PCI in patients with STEMI and multivessel coronary artery diseases.

Coronary Artery Disease 40

Coronary Artery Disease Myocardial Infarction STEMI Thrombosis 40

American College of Cardiology

SEPTEMBER 1, 2024

An invasive treatment strategy involving coronary angiography and revascularization plus medical therapy did not significantly lower the composite risk of cardiovascular death or nonfatal myocardial infarction (MI) compared with a conservative strategy of medical therapy alone in older adults with NSTEMI, according to findings from the SENIOR-RITA (..)

STEMI 48

STEMI Myocardial Infarction Article 48

Dr. Smith's ECG Blog

JULY 19, 2024

It was read by the treating physician and the overreading cardiologist as "Paced, no STEMI." Immediate and early percutaneous coronary intervention in very high risk and high risk non-ST segment elevation myocardial infarction patients. How does the Queen of Hearts do? Ann Emerg Med [Internet]. 2012;60:766–776. 2023;131569.

Chest Pain 115

Chest Pain Myocardial Infarction Pacemaker STEMI 115

Journal of Cardiovascular Pharmacology

MAY 23, 2024

In this study, we investigated the safety and efficacy of fondaparinux sodium in post-percutaneous coronary intervention (PCI) anticoagulation therapy for patients with ST-segment elevation myocardial infarction. There are a total of 200 patients with ST segment elevation myocardial infarction underwent PCI and anticoagulation therapy.

Myocardial Infarction 40

Myocardial Infarction STEMI Hospital Article 40

Dr. Smith's ECG Blog

OCTOBER 22, 2024

Unfortunately, the cardiologist waited until the next day to refer the patient for angiography and intervention because patient did not meet criteria for "STEMI"." This is an enormous posterior infarct! And Olivier finishes with this commentary: "Yet another example in favor of abandoning STEMI criteria for diagnosing OMI.

Chest Pain 66

Chest Pain STEMI Myocardial Infarction Angioplasty 66

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 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

DAIC

APRIL 8, 2024

milla1cf Mon, 04/08/2024 - 18:07 April 8, 2024 — Implantation of the Impella CP micro-axial flow pump in the hours after a heart attack significantly increased the rate of survival at six months among people suffering cardiogenic shock, according to a study presented at the American College of Cardiology ’s Annual Scientific Session.

Heart Attack 52

Heart Attack Heart attacks Cardiogenic Shock Catheterization Laboratory 52

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4137939-A4137939, November 12, 2024. However, little is known about LOY and prognosis of ST-segment elevation myocardial infarction (STEMI).Hypothesis:We However, little is known about LOY and prognosis of ST-segment elevation myocardial infarction (STEMI).Hypothesis:We

Myocardial Infarction 40

Myocardial Infarction STEMI Cancer Risk Factors 40

Frontiers in Cardiovascular Medicine

MARCH 20, 2025

BackgroundContrast-induced acute kidney injury (CI-AKI) is a common complication in patients with ST-segment elevation myocardial infarction (STEMI) and is associated with an inflammatory response. Integrating IBI can improve the risk stratification of STEMI patients regarding CI-AKI.

Myocardial Infarction 52

Myocardial Infarction STEMI Risk Factors Hospital 52

Dr. Smith's ECG Blog

JANUARY 31, 2025

of patients with anterior myocardial infarction ( 1 ). This ECG pattern is my favorite example of how the STEMI criteria are fundamentally flawed. We have a series of 20 TIMI-0 LAD Occlusions that do meet STEMI criteria. Tall precordial T waves with depressed ST take-off: an early sign of acute myocardial infarction?

STEMI 113

STEMI Chest Pain Myocardial Infarction Ischemia 113

Dr. Smith's ECG Blog

DECEMBER 16, 2024

She had this ECG recorded: Obvious massive anterior STEMI She was quickly brought to the critical care area and the cath lab was activated. Here is the ECG at 25 minutes: Terrible LAD STEMI (+) OMI So a CT scan was done which of course showed a normal aorta. This time the Queen of Hearts interpreted: No STEMI or Equivalent.

Chest Pain 105

Chest Pain Aortic STEMI Ultrasound 105

Dr. Smith's ECG Blog

NOVEMBER 8, 2024

This OMI went unrecognized and, had the artery not re-perfused by itself, the patient could have suffered a very large myocardial infarction. The Queen of Hearts AI model confidently identifies the first ECG in today's case as occlusion myocardial infarction (OMI HIGH confidence). He was diagnosed with NSTEMI.

Chest Pain 101

Chest Pain Myocardial Infarction Hypertension Hospital 101

Dr. Smith's ECG Blog

JANUARY 21, 2025

It is correct that he did not have chest pain, but we must remember that fully 1/3 of full blown STEMI do not present with chest pain. They made a final diagnosis of type II myocardial infarction. This is extremely elevated for a type 2 MI and totally consistent with STEMI. The EKG shows inferior OMI.

Chest Pain 62

Chest Pain STEMI Tachycardia Myocardial Infarction 62

Dr. Smith's ECG Blog

NOVEMBER 23, 2024

It is diagnostic of OMI, but this is SUBACUTE OMI I sent this ECG to my "EKG Nerdz" friends, without any clinical info at all and they answered "OMI" The Queen said: "STEMI-Equivalent with High Confidence:" Notice she sees findings in both normal beats and PVCs. The November 8, 2024 post — artifact complicating OMI assessment.

Blog 63

Blog Chest Pain Myocardial Infarction Critical Care 63

Dr. Smith's ECG Blog

OCTOBER 30, 2024

All of these findings together makes this ECG diagnostic of inferior and posterior occlusion myocardial infarction (OMI) The patient is this case was treated as if he had an ongoing OMI. When looking at the precordial leads there is appreciable slight ST depression in lead V2 and inappropriately isoelectric ST segment i lead V3.

Chest Pain 111

Chest Pain Aortic Myocardial Infarction STEMI 111

Dr. Smith's ECG Blog

OCTOBER 27, 2024

The cath lab was deactivated by cardiologist on arrival at ED because it was "not a STEMI". Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients. Pt received 324 ASA and 2 sprays of nitro with improvement. Pain was decreased to 2/10.

STEMI 121

STEMI Chest Pain Myocardial Infarction Aneurysm 121