Blog Ischemia STEMI 
Ken Grauer, MD
DECEMBER 1, 2023
For full discussion of this case — See ECG Blog #351 — == The ECG in Figure-1 — was obtained from a previously healthy older man who contacted EMS ( E mergency M edical S ervices ) because of "chest tightness" that began ~1 hour earlier. ECG Blog #205 = The Systematic Approach I favor. . =
Ken Grauer, MD
DECEMBER 15, 2023
For full discussion of this case — See ECG Blog #392 — == The ECG in Figure-1 was obtained from a man in his 60s — who described the sudden onset of "chest tightness" that began 20 minutes earlier, but who now ( at the time this ECG was recorded ) — was no longer having symptoms. ECG Blog #387 — Dynamic change in 2 minutes.
Ken Grauer, MD
AUGUST 8, 2024
PEARL # 3: While not 100% predictive — seeing a significant negative component to the P wave in these leads ( as per the YELLOW arrows in Figure-2 ) — suggests that the V1,V2 electrodes may be placed 1 or 2 interspaces too high on the chest ( See ECG Blog #274 — for more on too high placement of the V1,V2 electrode leads ).
Ken Grauer, MD
DECEMBER 8, 2023
For full discussion of this case — See ECG Blog #292 — == The 2 ECGs shown in Figure-1 were obtained from a man in his 30s — who presented to the ED ( E mergency D epartment ) with chest pain that began several hours earlier. Related ECG Blog Posts to Today’s Case: ECG Blog #205 — Reviews my Systematic Approach to 12-lead ECG Interpretation.
Ken Grauer, MD
OCTOBER 21, 2023
PEARL # 1: Although seeing an elevated Troponin would provide additional support for immediate cardiac catheterization — the clinical reality is that the initial Troponin reading will not always be elevated in patients with acute coronary occlusion ( See March 24, 2023 post in Dr. Smith's ECG Blog ).
Ken Grauer, MD
MAY 20, 2023
Voltage for LVH is satisfied — at least by Peguero Criteria ( Sum of deepest S in any chest lead + S in V4 ≥23 mm in a woman — as discussed in ECG Blog #73 ). Smith's ECG Blog — Drs. Figure-3: Selected sets of V1,V2 leads from the examples of Precordial Swirl provided in the October 15, 2022 post in Dr. Smith's ECG Blog.
Ken Grauer, MD
MAY 26, 2023
This ST depression appears to be maximal in leads V3-to-V5 — which could reflect acute posterior OMI ( O cclusion-based M yocardial I nfarction ) — most probably with multi -vessel disease ( ie, diffuse subendocardial ischemia suggested by the ST depression with ST elevation in aVR>V1 ). ECG Blog #316 — The patient died.
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