Atrial Flutter Myocardial Infarction STEMI 
Dr. Smith's ECG Blog
FEBRUARY 9, 2024
Written by Jesse McLaren A 65 year old with a history of atrial flutter, CABG and end-stage renal disease on dialysis presented with 3 days of fluctuating chest pain, which was ongoing at triage. Non-STEMI’ diagnostic momentum Cardiology repeated the ECG and troponin, and did a bedside echo. What do you think?
Dr. Smith's ECG Blog
MAY 8, 2023
Code STEMI was activated by the ED physician based on the diagnostic ECG for LAD OMI in ventricular paced rhythm. This was several months after the 2022 ACC Guidelines adding modified Sgarbossa criteria as a STEMI equivalent in ventricular paced rhythm). LAFB, atrial flutter, anterolateral STEMI(+) OMI.
Dr. Smith's ECG Blog
JUNE 27, 2021
Angiogram: "ACS - Non ST Elevation Myocardial Infarction. Meyers note: notice in their documentation many of the classic mistakes of the STEMI generation: "Non ST Elevation MI" as their reasoning for why the patient did not merit emergent reperfusion, while simultaneously calling it "emergently" (after 8 hours!!!)
Dr. Smith's ECG Blog
NOVEMBER 26, 2018
The axiom of "type 1 (ACS, plaque rupture) STEMIs are not tachycardic unless they are in cardiogenic shock" is not applicable outside of sinus rhythm. Therefore this patient is either in some form of SVT or atrial flutter. Atrial flutter, when regular, must be conducting at 1:1, 2:1, 3:1, etc. If so, why?
Dr. Smith's ECG Blog
JULY 14, 2023
So we activated the Cath Lab Angiogram: Impression and Recommendations: Culprit for the patient's anterior ST segment myocardial infarction and out of hospital V-fib cardiac arrest is a thrombotic occlusion of the mid LAD The first troponin returned barely elevated at 36 ng/L (URL = 35) In our study of initial troponin in STEMI, 26.8%
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