Academic Arrhythmia STEMI 
Dr. Smith's ECG Blog
SEPTEMBER 29, 2023
In the available view of the sinus rhythm, we see normal variant STE which probably meets STEMI criteria in V4 and V5. In other words, the inferior "ST elevation" is due to the abnormal rhythm, and does not signify OMI or STEMI in any way. This situation has been named "Emery phenomenon." YOU TOO CAN HAVE THE PM Cardio AI BOT!!
Dr. Smith's ECG Blog
MARCH 31, 2023
This was marked as "Not a STEMI" by the physicians. It is not a STEMI, but it is diagnostic of an LAD OMI (Occlusion MI). In my opinion — AI is not yet "there" with regard to interpretation of complex cardiac arrhythmias. As noted by Dr. Smith — No one could miss the acute STEMI in the repeat ECG in today's case.
Dr. Smith's ECG Blog
APRIL 22, 2019
The computer called it a normal ECG Algorithm unknown Aside : [There is some "sinus arrhythmia", which is indeed a normal finding. Sinus arrhythmia is sinus rhythm whose rate varies with respiration. If the longest P-P interval is 120 ms greater than the shortest, it is sinus arrhythmia. Learning Points: 1.
Dr. Smith's ECG Blog
NOVEMBER 26, 2018
The axiom of "type 1 (ACS, plaque rupture) STEMIs are not tachycardic unless they are in cardiogenic shock" is not applicable outside of sinus rhythm. In some cases the ischemia can be seen "through" the flutter waves, whereas in other cases the arrhythmia must be terminated before the ischemia can be clearly distinguished.
Dr. Smith's ECG Blog
JULY 21, 2024
The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. However, he suddenly developed a series of malignant ventricular arrhythmias. Below are printouts of some of the arrhythmias recorded. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation.
Dr. Smith's ECG Blog
JUNE 13, 2024
See this post: Septal STEMI with ST elevation in V1 and V4R, and reciprocal ST depression in V5, V6. Case progression: The automated EKG interpretation was “sinus rhythm with sinus arrhythmia, right atrial enlargement, rightward axis, possible anterior infarct, age undetermined, abnormal ECG”. Also seen in inferior + RV OMI.)
Dr. Smith's ECG Blog
APRIL 9, 2025
The paramedics diagnosis was "Possible Anterolateral STEMI." More proof that a huge STEMI may have normal or near normal initial troponin. If breakthrough ventricular arrhythmias occurred, additional 50-mg boluses were given every 5 minutes, as needed to a maximum of 325 mg. The final angiographic result is very good.
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