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He has a great blog too: ECG Interpretation He is also well known on the Facebook EKG Club page , where you can learn tons about ECGs: Here is his response, with the first ECG labelled: Hello Steve & Avinash. Is there STEMI? It is commonly seen in the reperfusion setting. Most physicians, at first glance, get this wrong.
A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. Pediatric and elderly patients were more predisposed to developing an arrhythmic event in the setting of fever [7]. So maybe she is better than I am.
2) The STE in V1 and V2 has an R'-wave and downsloping ST segments, very atypical for STEMI. Cardiology was consulted and they agreed that the EKG had an atypical morphology for STEMI and did not activate the cath lab. Pediatric and elderly patients were more predisposed to developing an arrhythmic event in the setting of fever [7].
Even before we have clinical context, this ECG simply does not appear concerning for OMI, notwithstanding the machine's interpretation ** ** ACUTE MI / STEMI ** **. I suspect most blog readers did not struggle with this one. But in the world of STEMI, this is a challenging ECG to most. Figure-1: I've labeled today's ECG.
How well does the computer interpretation perform? -- in this case, the computer diagnosed STEMI but the patient had Fever with Brugada _ _ Fever and Brugada-- Important articles The literature below shows that fever-induced Brugada is indeed a high risk for an arrhythmic event. Syncope and ST Segment Elevation. And another finding.
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