Aneurysm Chest Pain Stent 
Dr. Smith's ECG Blog
SEPTEMBER 11, 2024
No Chest Pain, but somnolent. There are QS-waves in V1-V3 suggesting old anterior MI with persistent ST Elevation (LV aneurysm morphology), but I have written a couple papers showing that in LV aneurysm, the T-wave is not > 0.36 But the T-waves in LV aneurysm are not this big. LV Aneurysm vs New Infarction?
Dr. Smith's ECG Blog
JANUARY 27, 2024
Written by Jesse McLaren, comments by Smith A 55 year old with a history of NSTEMI presented with two hours of exertional chest pain, with normal vitals. Old ‘NSTEMI’ A history of coronary artery disease and a stent to the same territory further increases pre-test likelihood of acute coronary occlusion, including in-stent thrombosis.
Dr. Smith's ECG Blog
NOVEMBER 17, 2023
It is of an elderly woman who complained of shortness of breath and had a recent stent placed. LV aneurysm has QS-waves, so this couldn't be LV aneurysm, right? RBBB makes it mandatory that there are R'-waves even in the presence of LV aneurysm. Also, we know the patient had a stent. What do you think?
Dr. Smith's ECG Blog
NOVEMBER 26, 2015
52-year-old lady presents to the Emergency Department with 2 hours of chest pain, palpitations & SOB. However, old MI w/aneurysm morphology (persistent ST-Elevation) can look just like this. Old MI w/Aneurysm will show moderate ST Elevation, as seen here. Notice also that no lead has 1 mm of ST elevation.
Dr. Smith's ECG Blog
JANUARY 6, 2023
Submitted and written by Anonymous, edits by Meyers and Smith A 50s-year-old patient with no known cardiac history presented at 0045 with three hours of unrelenting central chest pain. The pain was heavy, radiated to her jaw with an associated headache. A single DES stent was placed, and the patient did well post-procedure.
Dr. Smith's ECG Blog
APRIL 12, 2013
A male in his 40's who had been discharged 6 hours prior after stenting of an inferoposterior STEMI had sudden severe SOB at home 2 hours prior to calling 911. He had no chest pain. Inferior LV "aneurysm" morphology Electrocardiographic "LV Aneurysm" morphology simply means "persistent ST elevation after previous MI."
Dr. Smith's ECG Blog
SEPTEMBER 27, 2019
An elderly woman presented with chest pain that radiated to the back for several hours. The first troponin returned at 0.099 ng/mL (elevated, consistent with Non-Occlusion MI) Providers were concerned with aortic dissection, so they order a chest aorta CT. Here is here initial ECG: There is only a nonspecific flat T-wave in aVL.
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