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Pulmonary edema, with tachycardia and OMI on the ECG -- what is going on?

Dr. Smith's ECG Blog

There are no Q-waves to suggest old inferior MI, or inferior aneurysm as the etiology of the ST Elevation. Whenever there is tachycardia, I am skeptical of OMI unless it has led to severely compromised ejection fracction with cardiogenic shock. Or I suspect that there is OMI simultaneous with another pathology.