Remove Angioplasty Remove Echocardiogram Remove Myocardial Infarction
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An elderly male with shortness of breath

Dr. Smith's ECG Blog

Timing of revascularization in patients with transient ST segment elevation myocardial infarction: a randomized clinical trial. A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty. Eur Heart J 2018.

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First ED ECG is Wellens' (pain free). What do you think the prehospital ECG showed (with pain)?

Dr. Smith's ECG Blog

For those who depend on echocardiogram to confirm the ECG findings of ischemia, this should be sobering. Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. The peak troponin I was 0.364 ng/ml.

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Precordial ST depression. What is the diagnosis?

Dr. Smith's ECG Blog

Seventh , an immediate echocardiogram can make the distinction. New electrocardiographic criteria for posterior wall acute myocardial ischemia validated by a percutaneous transluminal coronary angioplasty model of acute myocardial infarction. At lease 0.5 Am J Cardiol 2001;87(8):970-4.

STEMI 52
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A Tough ECG, But Learn From It!

Dr. Smith's ECG Blog

On echocardiogram, there was a 40% ejection fraction with anterior wall motion abnormality. Acute Myocardial Infarction Due to Left Circumflex Artery Occlusion and Significance of ST-Segment Elevation. Incidence Incidence, angiographic features and outcomes of patients presenting with subtle ST-elevation myocardial infarction.

STEMI 52
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A young peripartum woman with Chest Pain

Dr. Smith's ECG Blog

Troponins, echocardiogram An echocardiogram showed inferobasilar hypokinesis, further supporting a diagnosis of regional ischemia , likely of the area supplied by the RCA. Revascularization in Patients With Spontaneous Coronary Artery Dissection and ST-Segment Elevation Myocardial Infarction. ng/ml (99th %-ile URL = 0.04

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Why you should use the Queen of Hearts and record serial ECGs more often. If you wait for troponin.

Dr. Smith's ECG Blog

Successful primary angioplasty of the mid-circumflex artery towards the main marginal branch with the implantation of a drug-eluting stent. The echocardiogram shows a preserved left ventricular ejection fraction (LVEF) of 55% with marked basal and mid inferolateral and basal anterolateral hypokinesia. Good angiographic result.

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A dialysis patient with nonspecific symptoms and pseudonormalization of ST segments

Dr. Smith's ECG Blog

I think a good start would be a posterior EKG and a high quality contrast echocardiogram read by an expert. The lesion was intervened on with balloon angioplasty and had subsequent TIMI 3 flow. Occlusion Myocardial Infarction (OMI) often does not present with diagnostic ST elevation, or even any STE, especially in dialysis patients.