Aneurysm Hypertension STEMI 
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. Is this acute STEMI? Is this an acute STEMI? -- Unlikely! The hypertension alone is the likely etiology of the pulmonary edema. He had no chest pain.
Dr. Smith's ECG Blog
JANUARY 27, 2024
Smith : Old inferior MI with persistent ST Elevation ("inferior aneurysm") has well-formed Q-waves. In inferior aneurysm, we usually see QR-waves, whereas for anterior aneurysm, we see QS-waves (no R- or r-wave at all!). So this NSTEMI was likely a STEMI(-)OMI with delayed reperfusion. Deutch et al.
Dr. Smith's ECG Blog
NOVEMBER 26, 2015
She is somewhat hypertensive, but her vital signs are otherwise normal. These elevations meet STEMI criteria ( ≥ 1mm in 2 contiguous leads). However, old MI w/aneurysm morphology (persistent ST-Elevation) can look just like this. In STEMI, they are generally upright and large in proportion to the QRS.
Dr. Smith's ECG Blog
DECEMBER 29, 2015
Her vitals signs were remarkable for marked hypertension. would require the ST/S ratio to be 25% for diagnosis of STEMI in LVH. The physician was concerned about STEMI, but also worried that she was overreacting, with the potential that LVH was producing a "STEMI-mimic." Is LVH like left ventricular aneurysm?
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. Past medical history included diabetes and hypertension.
Dr. Smith's ECG Blog
APRIL 17, 2023
The Queen of Hearts correctly says: Smith : Why is this ECG which manifests so much ST Elevation NOT a STEMI (even if it were a 60 year old with chest pain)? He was mildly tachycardic (105-110 bpm) and hypertensive (157/92 mm Hg) on arrival. Physician interpretation: "No STEMI." Physician: "No STEMI."
Dr. Smith's ECG Blog
OCTOBER 20, 2013
A middle-age woman with h/o hypertension was found down by her husband. Note that they finally have laid to rest the new or presumably new LBBB as a criteria for STEMI. Note that they finally have laid to rest the new or presumably new LBBB as a criteria for STEMI. With ventilations and epinephrine, she regained a pulse.
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