Article Electrocardiogram STEMI 
Dr. Smith's ECG Blog
JULY 31, 2020
Their OMI Manifesto details how use of standard STEMI criteria results in an unacceptable level of inaccuracy, in which an estimated 25-30% of acute coronary occlusions are missed! The article by Aslanger, Smith et al that is featured above in today’s post has just been published.
Dr. Smith's ECG Blog
SEPTEMBER 26, 2023
See these 2 articles Association between pre-hospital chest pain severity and myocardial injury in ST elevation myocardial infarction: A post-hoc analysis of the AVOID study Author links open overlay panel [link] 1 Background We sought to determine if an association exists between prehospital chest pain severity and markers of myocardial injury.
Dr. Smith's ECG Blog
MARCH 10, 2017
Safety of Computer Interpretation of Normal Triage Electrocardiograms. The cath lab was activated, as it should be with transient STEMI. See this case of transient STEMI: Spontaneous Reperfusion and Re-occlusion - My Bad Thinking Contributes to a Death. Here are two recent articles confirming this: a.
Dr. Smith's ECG Blog
JUNE 12, 2017
This is diagnostic of inferior MI, though does not meet millimeter criteria for "STEMI." He was worried for inferior MI and ordered another, which was recorded 15 minutes later: Now clearly and obviously diagnostic of inferior STEMI. Unknown algorithm Interpretation: Inferior ST elevation, with reciprocal ST depression in aVL.
Dr. Smith's ECG Blog
FEBRUARY 4, 2022
Regional wall motion abnormality-distal septum anterior and apex Today, shortly after this case presented, I received in my inbasket from Journal Feed this article which promotes the idea that "normal" ECGs by computer do not need to be overread by a physician. Am J Emerg Med. 2022 Jan;51:384-387. doi: 10.1016/j.ajem.2021.11.023. 2021.11.023.
Dr. Smith's ECG Blog
JUNE 11, 2024
Many systems now refrain from showing computer "normal" ECGs to the busy emergency physicians at triage because of very poorly conceived articles that say that if the computer algorithm says "normal," the emergency physician should not be bothered. At this point — a STEMI was diagnosed, and cardiac cath with PCI was performed.
Dr. Smith's ECG Blog
MARCH 14, 2024
We also studied 7 years of Code STEMI patients requiring emergent reperfusion, and found that 4% presented with an ECG labeled ‘normal’, often confirmed by the final blinded interpretation. Emergency department Code STEMI patients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review.
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