Remove Angioplasty Remove Electrocardiogram Remove Ischemia
article thumbnail

Is OMI an ECG Diagnosis?

Dr. Smith's ECG Blog

5] Back to the case The patient had serial ECGs over the next hour with no significant change: The first troponin came back at 1,400 ng/L (normal <26 in males and <16 in females), confirming MI – and the patient’s refractory ischemia indicated this was an Occlusion MI. Clin Cardiol 2022 4. Herman, Meyers, Smith et al.

STEMI 121
article thumbnail

Right precordial ST depression in a patient with chest pain

Dr. Smith's ECG Blog

Computer read: "Non-specific ST abnormality, consider anterior subendocardial ischemia" There are very poor R-waves in V1-V4 suggesting old anterior MI. Firstly, subendocardial ischemia does not localize on 12-Lead ECG. But the real question at hand is: Are these precordial ST-depressions a result of subendocardial ischemia?

article thumbnail

How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

Post by Smith and Meyers Sam Ghali ( [link] ) just asked me (Smith): "Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR?" That said, complete LM occlusion would be expected to have subepicardial ischemia (STE) in these myocardial territories: STE vector 1.

article thumbnail

Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused

Dr. Smith's ECG Blog

The patient continued to have ischemia after PCI, and in fact had an episode of polymorphic VT shortly after while in the ICU. Determinants and prognostic implications of persistent ST-segment elevation after primary angioplasty for acute myocardial infarction: importance of microvascular reperfusion injury on clinical outcome.

STEMI 52