Aneurysm Cardiogenic Shock STEMI 
Dr. Smith's ECG Blog
OCTOBER 26, 2010
He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. At first glance, it seems the patient is having a STEMI. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock.
Dr. Smith's ECG Blog
JULY 18, 2014
Thus, this is BOTH an anterior and inferior STEMI in the setting of RBBB. How old is this antero-inferior STEMI? Although acute anterior STEMI frequently has narrow QR-waves within one hour of onset (1. the presence of such well developed, wide, anterior Q-wave suggests completed transmural STEMI. Could it be acute (vs.
Dr. Smith's ECG Blog
OCTOBER 17, 2024
The prehospital and ED computer interpretation was inferior STEMI: There’s normal sinus rhythm, first degree AV block and RBBB, normal axis and normal voltages. The paramedic notes called STEMI into question: “EMS disagree with monitor for STEMI callout. Vitals were normal except for oxygen saturation of 94%. Vitals were normal.
Dr. Smith's ECG Blog
AUGUST 13, 2020
Because of the tachcardia, I would expect her to be very poor left ventricular function and maybe Cardiogenic shock. Old MI with persistent ST Elevation (LV aneurysm morphology) can look like acute MI 2. Not all anterior LV aneurysm has a QS-wave. LV Aneurysm? Learning Points: 1. Would you give Thrombolytics?
Dr. Smith's ECG Blog
MARCH 3, 2025
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. Supply-demand mismatch can cause ST Elevation (Type 2 STEMI). Management?
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