Dr. Smith's ECG Blog

APRIL 22, 2019

He then went on to say: "40-something with chest pain for one hour. Burning pain subxiphoid and into throat." Still does not meet STEMI criteria, but it is an obvious OMI And then another one became more obvious: Cath lab was activated and a 100% RCA occlusion was found. Sounds like reflux, right? Learning Points: 1.

Chest Pain 52

Chest Pain Arrhythmia Ischemia STEMI 52

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Recall from this post referencing this study that "reciprocal STD in aVL is highly sensitive for inferior OMI (far better than STEMI criteria) and excludes pericarditis, but is not specific for OMI." See this case: Persistent Chest Pain, an Elevated Troponin, and a Normal ECG. See this case: A man his 50s with chest pain.

Myocardial Infarction 123

Myocardial Infarction Chest Pain STEMI Blood Pressure 123

Dr. Smith's ECG Blog

AUGUST 2, 2024

Written by Willy Frick A 50 year old man with no medical history presented with acute onset substernal chest pain. This was a machine read STEMI positive OMI. His ECG is shown below. Pretty obvious anterior current of injury. Readers of this blog can easily appreciate the hyperacute T waves in the precordium, clearest in V1-V4.

STEMI 119

STEMI Ischemia Blog Chest Pain 119

Dr. Smith's ECG Blog

AUGUST 26, 2009

This is a 58 year old male with 40 minutes of chest pain of acute onset. He called 911 and paramedics recorded a prehospital 12 lead ECG which showed a clear inferior STEMI (not shown, tracing could not be found). He was given aspirin and sublingual nitroglycerine, which improved his pain. 18 (5 Suppl 1):Abstract 425, p.

STEMI 52

STEMI Catheterization Laboratory Chest Pain Myocardial Infarction 52

Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

Sent by anonymous, edited by Pendell Meyers A man in his 50s with history only of hypertension presented with acute chest pain that started 45 minutes prior to presentation while doing yard work. Post Cath ECG: Obviously completing MI with LVA morphology, and STE that meets STEMI criteria (but pt is still diagnosed as "NSTEMI").

STEMI 78

STEMI Myocardial Infarction Ischemia Academic 78

Dr. Smith's ECG Blog

JUNE 12, 2017

This was sent by : Jacob Smith, DO Emergency Medicine Resident Ohio Health Doctors Hospital Emergency Residency Christopher Lloyd, DO, FACEP Director of Clinical Education, USACS Midwest Case A 30 year old patient presents to triage with chest pain. This is diagnostic of inferior MI, though does not meet millimeter criteria for "STEMI."

Chest Pain 52

Chest Pain STEMI Myocardial Infarction Electrocardiogram 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. This episode of chest pain began 3 hours ago and was persistent even at rest. Troponin was ordered.

Chest Pain 83

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 83

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

Code STEMI was activated. What is the Diagnosis in this 70-something with Chest Pain? 68 minutes with chest compressions, full recovery. A man in his 80s with chest pain What, besides large anterior STEMI, is so ominous about this ECG? The patient arrived to the ED in cardiogenic shock but awake.

Chest Pain 52

Chest Pain Cardiogenic Shock Tachycardia Ischemia 52

EMS 12-Lead

APRIL 14, 2022

Factors consistently manifesting as such, in addition to chest pain, include, diaphoresis, vomiting, radiation of pain (most alarming when inclusive of both arms), and pain aggravated by exertion. [1] It should be emphasized here that this is a presentation of high-pretest probability for Acute Coronary Syndrome (ACS).

ACE Inhibitor 52

ACE Inhibitor Physiology Chest Pain Academic 52

Dr. Smith's ECG Blog

MARCH 14, 2025

He has a history of coronary artery disease and a STEMI two years prior that was treated with primary PCI. He contacted EMS due to acute onset chest pain and feeling unwell and fatigued. He subsequently developed worsening chest pain. Pain is improving and ischemic T-wave inversions are no longer present".

Chest Pain 106

Chest Pain STEMI Myocardial Infarction Ischemia 106