Remove Anatomy Remove Coronary Angiogram Remove STEMI
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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. aVR ST segment elevation: acute STEMI or not? Incidence of an acute coronary occlusion.

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A coronary angiogram, that tends to cross the boundaries of your thoughts

Dr. S. Venkatesan MD

2017 ) Clinical implication of such coronary anomalies Apart from angiographic surprises, these anomalous coronary arteries may under-perfuse the ventricle and present as unexplained cardiomyopathy , until we realize the anatomical errors in coronary anatomy. We know, how adverse is the outcome of Left main STEMI.

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A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

50% of LAD STEMIs do not have reciprocal findings in inferior leads, and many LAD OMIs instead have STE and/or HATWs in inferior leads instead. The ECG easily meets STEMI criteria in all leads V2-V6, as well. 24 yo woman with chest pain: Is this STEMI? This is not "diffuse", this is simply anterior, lateral, and likely apical.