Angina Echocardiogram STEMI 
Dr. Smith's ECG Blog
JUNE 18, 2011
This is a 45 yo male who had an inferior STEMI 6 months prior, was found to have severe LAD and left main disease, and was supposed to be set up for CABG a few weeks later, but did not follow up. But it could be anterior STEMI. 40% of anterior STEMI has upward concavity in all of leads V2-V6. is likely anterior STEMI).
Dr. Smith's ECG Blog
DECEMBER 19, 2023
The commonest causes of MINOCA include: atherosclerotic causes such as plaque rupture or erosion with spontaneous thrombolysis, and non-atherosclerotic causes such as coronary vasospasm (sometimes called variant angina or Prinzmetal's angina), coronary embolism or thrombosis, possibly microvascular dysfunction.
Dr. Smith's ECG Blog
NOVEMBER 15, 2013
You've read in my previous posts that I have a lot of evidence that Wellens' represents spontaneously reperfused STEMI in which the STEMI went unrecorded. New ST elevation diagnostic of STEMI [equation value = 25.3 Silent ischemia as a marker for early unfavorable outcomes in patients with unstable angina.
Dr. Smith's ECG Blog
JANUARY 1, 2013
A middle aged male with no h/o CAD presented with one week of crescendo exertional angina, and had chest pain at the time of the first ECG: Here is the patient's previous ECG: Here is the patient's presenting ED ECG: There is isolated ST depression in precordial leads, deeper in V2 - V4 than in V5 or V6. There is no ST elevation.
Dr. Smith's ECG Blog
MARCH 9, 2013
Here is the prehospital ECG, with pain: Hyperacute anterolateral STEMI The medics had activated the cath lab and the patient went for angiogram and had a 95% stenotic LAD with TIMI-3 flow. For those who depend on echocardiogram to confirm the ECG findings of ischemia, this should be sobering. Type B waves are deeper and symmetric.
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
Takotsubo is a sudden event, not one with crescendo angina. Here is the cath report: Echocardiogram: There is severe hypokinesis of entire LV apex and apical segment of all the walls. This has resulted in an under-representation of STEMI MINOCA patients in the literature. Learning Points: 1. From Gue at al.
Dr. Smith's ECG Blog
JULY 3, 2018
Despite ongoing chest discomfort and an uptrending troponin, he never meets STEMI criteria. No further echocardiograms were available after cath. As has been mentioned numerous times on this site and is redemonstrated here: expert, subjective ECG interpretation is superior to STEMI criteria.
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