Aneurysm STEMI Stent 
Dr. Smith's ECG Blog
OCTOBER 27, 2024
The cath lab was deactivated by cardiologist on arrival at ED because it was "not a STEMI". No thoracic aortic hematoma, aneurysm or dissection. First obtuse marginal also had an 80% stenosis and was stented. Pt received 324 ASA and 2 sprays of nitro with improvement. Cath lab was activated by EMS and transported emergent."
Dr. Smith's ECG Blog
JANUARY 27, 2024
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. The patient had a history of ‘NSTEMI’ a decade prior, with an RCA stent. So this NSTEMI was likely a STEMI(-)OMI with delayed reperfusion.
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! He had no chest pain. Medications were aspirin, clopidogrel, metoprolol, and simvastatin.
Dr. Smith's ECG Blog
JANUARY 28, 2023
Only very slight STE which does not meet STEMI criteria at this time. I am immediately worried that this OMI will not be understood, for many reasons including lack of sufficient STE for STEMI criteria, as well as the common misunderstanding of "no reciprocal findings" which is very common with this particular pattern. 6.5 = 0.38.
Dr. Smith's ECG Blog
OCTOBER 15, 2024
A prehospital “STEMI” activation was called on a 75 year old male ( Patient 1 ) with a history of hyperlipidemia and LAD and Cx OMI with stent placement. The EKG is diagnostic of acute inferior, posterior, and lateral OMI superimposed on “LV aneurysm” morphology. It was stented. He wrote most of it and I (Smith) edited.
Dr. Smith's ECG Blog
NOVEMBER 26, 2015
These elevations meet STEMI criteria ( ≥ 1mm in 2 contiguous leads). However, old MI w/aneurysm morphology (persistent ST-Elevation) can look just like this. While this may be change that is reciprocal to an Acute/Subacute Inferior STEMI, the problem is that LV aneurysm may also manifest with this reciprocal change.
Dr. Smith's ECG Blog
DECEMBER 29, 2015
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." Can you diagnose an ACO (STEMI) when you also have LVH? Is LVH like left ventricular aneurysm?
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