Dr. Smith's ECG Blog

DECEMBER 11, 2023

Recall from this post referencing this study that "reciprocal STD in aVL is highly sensitive for inferior OMI (far better than STEMI criteria) and excludes pericarditis, but is not specific for OMI." The ESC states that patients with suspected ACS should go to the cath lab in ＜2 hours "regardless of ECG or biomarker evidence of MI!!"

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Myocardial Infarction Chest Pain STEMI Blood Pressure 123

Circulation

NOVEMBER 11, 2024

This study investigates the relationship between baseline 5-HTP levels and the incidence of major adverse cardiovascular events (MACE) in patients who have experienced ST-elevation myocardial infarction (STEMI).Objective:Our Conclusion:Higher 5-HTP levels are independently associated with a reduced risk of MACE in patients after STEMI.

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Myocardial Infarction Coronary Artery Bypass Graft STEMI Angina 40

Dr. Smith's ECG Blog

JANUARY 3, 2022

Step 1 to missing posterior MI is relying on the STEMI criteria. A prospective validation of STEMI criteria based on the first ED ECG found it was only 21% sensitive for Occlusion MI, and disproportionately missed inferoposterior OMI.[1] But it is still STEMI negative. A 15 lead ECG was done (below). In a study last year, 14.4%

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STEMI Myocardial Infarction Chest Pain Ischemia 52

Dr. Smith's ECG Blog

MARCH 2, 2009

By definition, this is a non-STEMI because there is not 1 mm of ST elevation in 2 consecutive leads. Even though the patient's ECG did not meet criteria for STEMI, he had all the pathology of a STEMI. Even though the patient's ECG did not meet criteria for STEMI, he had all the pathology of a STEMI.

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Heart attacks Heart Attack STEMI Echocardiogram 52

Dr. Smith's ECG Blog

JUNE 18, 2013

His ECG was repeated at this point: This shows a well developed anterior STEMI. To not see these findings is very common, and this patient would be given the diagnosis of NonSTEMI, with subsequent development of STEMI. It is not a missed STEMI, but it is a missed coronary occlusion. The peak troponin I was over 100.

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STEMI Chest Pain Myocardial Infarction Webinar 52

Dr. Smith's ECG Blog

AUGUST 9, 2024

Frick -- one wonders about the diagnosis of unstable angina in a patient with significantly elevated biomarkers which would certainly have been rising on repeat measurement.) The receiving emergency physician consulted with interventional cardiology who stated there was no STEMI. Is there STEMI? What is the rhythm? Moffat, M.

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Chest Pain Arrhythmia Myocardial Infarction STEMI 107

Dr. Smith's ECG Blog

DECEMBER 22, 2023

The ESC states that patients with suspected ACS should go to the cath lab in ＜2 hours "regardless of ECG or biomarker evidence of MI!!" Comment : ACS with persistent symptoms is a guideline recommended indication for ＜2 hour angio (both ACC/AHA and ESC). Therefore, we activate the Cath Lab.

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Chest Pain Bradycardia Blog Electrocardiogram 116

Circulation

NOVEMBER 11, 2024

Considering their multidirectional effect on atherosclerosis, new inflammatory biomarkers integrating various leukocyte subgroups have been proposed to calculate the systemic inflammatory response index (SIRI) and systemic inflammatory index (SII).Aim:The The mean age of patients was 57.68 (SD= 11.19) years.

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Angina Coronary Artery Disease Biomarkers Atherosclerosis 40

Dr. Smith's ECG Blog

DECEMBER 14, 2016

The "criteria" for posterior STEMI are 0.5 Is it STEMI or NonSTEMI? It was opened and stented with a door to balloon time of about 120 minutes (this is long for STEMI, but very short for a high risk Non STEMI). The troponin I returned at 4.1 ng/mL (ULN = 0.030 ng/mL) , diagnostic of myocardial injury. mm STE in one lead.

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Chest Pain STEMI Aortic Myocardial Infarction 52

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. Limkakeng AT.

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Chest Pain Myocardial Infarction STEMI Pacemaker 52

Dr. Smith's ECG Blog

AUGUST 26, 2019

The ECG progression, clinical picture, and biomarkers are also involved in the full diagnosis of OMI. This one likely does meet STEMI criteria in II, III, and aVF. The development of an inferior-posterior STEMI, from prehospital to hospital Inferior hyperacute T-waves. Criteria for a STEMI are definitely not met in ECG #1.

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Chest Pain STEMI Biomarkers Article 52

Open Heart

OCTOBER 23, 2024

Using person-linked hospitalisation data, we compared International Classification of Diseases (ICD)-coded data with biomarker-classified admission rates for ST-segment elevation MI (STEMI), non-STEMI (NSTEMI) and unstable angina (UA) in Western Australia (WA). Results There were 37 272 ACS admissions in 30 683 patients (64.2%

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Biomarkers Hospital STEMI Myocardial Infarction 52

Dr. Smith's ECG Blog

MAY 21, 2012

In acute STEMI, the T-wave is large, whereas in LV aneurysm , the T-wave is not so large. If greater than or equal to 0.22 , then acute anterior STEMI. correlates with anterior STEMI) Rule 2. If there is any one lead of V1-V4 with a T/QRS ratio greater than 0.36, then it is likely to be anterior STEMI. Answer below.

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STEMI Chest Pain Aneurysm Biomarkers 40

Dr. S. Venkatesan MD

JANUARY 22, 2025

The fear comes built in with the diagnosis often amplified by young felllows on call (& often times by senior consultants as well) It may appear real, from a clinical angle, but trust, when we deal with the whole gamut of so-called ACS (other than STEMI), there is indeed a benign face in many of them.

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Coronary Angiogram Chest Pain Anatomy Angina 52

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

50% of LAD STEMI have Q-waves by one hour. Smith : In limb leads, the ST vector is towards lead II (STE lead II STE lead III, which is more likely with pericarditis than with STEMI). This correlates with potentially salvageable myocardium. See Raitt et al.: These findings together are more commonly seen with pericarditis.

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Chest Pain Pericarditis Myocardial Infarction Dementia 89