2025 Bradycardia STEMI 
Dr. Smith's ECG Blog
FEBRUARY 20, 2025
A 12-lead was recorded, showing "STEMI," but is unavailable. Moreover, if you know that catastrophic intracranial hemorrhage can result in an ECG that mimics STEMI, then you know that this patient probably has a severe intracranial hemorrhage. She was BVM ventilated and suctioned. Shortly thereafter, pulses were lost.
Dr. Smith's ECG Blog
FEBRUARY 10, 2025
Theres sinus bradycardia, borderline PR interval, narrow QRS; normal axis/R wave progression; low precordial voltages, and subtle peaked T waves (most obvious in V2, but all T waves are symmetric with a narrow base). Theres no prior ECG to compare - but the bradycardia, prolonged PR and peaked T waves could all be from hyperkalemia.
Dr. Smith's ECG Blog
MARCH 19, 2025
Despite the baseline artifact theres sinus bradycardia, convex ST elevation in III, reciprocal ST depression in aVL and possible anterior ST depression indicating inferoposterior OMI. STEMI criteria are only 43% sensitive for OMI. Beware confusing the diagnosis of posterior STEMI by using posterior leads.
Dr. Smith's ECG Blog
FEBRUARY 14, 2025
Vitals were within normal limits except bradycardia. Sinus bradycardia, normal QRS. The ECG meets STEMI criteria objectively. Abdominal Pain in a middle-aged patient True Positive ST elevation in aVL vs. False Positive ST elevation in aVL == MY Comment, by K EN G RAUER, MD ( 2/10/2025 ): == I find cases like today's challenging.
Dr. Smith's ECG Blog
MARCH 8, 2025
Within ten minutes, she developed bradycardia, hypotension, and ST changes on monitor. Bradycardia and heart block are very common in RCA OMI. There was indication of parasympathetic overdrive ( the acute inferior STEMI with profound bradycardia and junctional escape ). He told the patient this horrible news.
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