2025 Echocardiogram STEMI 
Dr. Smith's ECG Blog
FEBRUARY 16, 2025
The emergency medicine physician documented, "His initial EKG is riddled with artifact and difficult to interpret but does not look like a STEMI." The ECG remains positive for STEMI by GE. Echocardiogram was finally performed five hours after the first diagnostic ECG. The emergency physician consulted cardiology.
Dr. Smith's ECG Blog
MARCH 17, 2025
Echocardiogram showed inferior hypokinesis. Limitations of registry data: This patient presented with STEMI (-) OMI and developed STEMI the following day. In the world of STEMI, we are incapable of recognizing the first ECG as a false negative. Angiogram is shown below. Troponin was rising when last checked, 8928 ng/L.
Dr. Smith's ECG Blog
FEBRUARY 2, 2025
Unfortunately, the ECG was interpreted as no significant change from prior , "no STEMI"!! Approximately 5 minutes after ROSC, this ECG was obtained (about 45 minutes after arrival): Obvious anterolateral OMI, and STEMI criteria positive for those who care or need it. He was sent back to the waiting room, where he suffered a VF arrest.
Dr. Smith's ECG Blog
MARCH 3, 2025
Supply-demand mismatch can cause ST Elevation (Type 2 STEMI). Also see these posts of Type II STEMI. An EKG from a year prior was available for comparison: The ED physician noted Initial EKG here read by the computer as a STEMI, however, there is a very poor baseline and a lot of artifact. See reference and discussion below.
Dr. Smith's ECG Blog
JANUARY 21, 2025
In this study of consecutive patients with LBBB who were hospitalized and had an echocardiogram, a QRS duration less than 170 ms (n = 262), vs. greater than 170 ms (n = 38), was associated with a significantly better ejection fraction (36% vs. 24%). This is extremely elevated for a type 2 MI and totally consistent with STEMI.
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