Bradycardia Heart Failure STEMI 
Dr. Smith's ECG Blog
MARCH 22, 2024
I will leave more detailed rhythm discussion to the illustrious Dr. Ken Grauer below, but this use of calipers shows that the rhythm interpretation is: Sinus bradycardia with a competing (most likely junctional) rhythm. For national registry purposes, this will be incorrectly classified as a STEMI.) Large STEMI are approximately 30-80.
EMS 12-Lead
MARCH 19, 2023
He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. It doesn’t meet any conventional STEMI criteria, but there is patently obvious increased area under the curve. No appreciable skin pallor. Is this OMI?
Dr. Smith's ECG Blog
FEBRUARY 15, 2018
Here are inferior leads, and aVL, magnified: A closer inspection of the inferior leads and aVL Sinus bradycardia. A right heart cath revealed increased right heart pressures and a similarly timed echo revealed mild right heart failure. I had no history on the case and no prior ECG for comparison. What do you think?
Dr. Smith's ECG Blog
MARCH 2, 2019
Does this patient have hypertension and/or heart failure that has worsened? In my experience, Ive seen U waves not only with low K+/low Mg++ but also in patients with bradycardia, LVH, and sometimes in normal subjects. This might be a common scenario given this patients demographics and his underlying disease ).
Dr. Smith's ECG Blog
APRIL 8, 2016
Here is his ED ECG: There is obvious infero-posterior STEMI. What are you worried about in addition to his STEMI? There is also bradycardia. Bradycardia puts patients at risk for "pause-dependent" Torsades de Pointes. Bradycardia puts patients at risk for "pause-dependent" Torsades de Pointes. Learning Points: 1.
Dr. Smith's ECG Blog
MARCH 19, 2025
Despite the baseline artifact theres sinus bradycardia, convex ST elevation in III, reciprocal ST depression in aVL and possible anterior ST depression indicating inferoposterior OMI. Heres the Queen of Hearts interpretation, drawing attention especially to III and aVL: This patient does indeed need emergent intervention.
Dr. Smith's ECG Blog
MARCH 8, 2025
Within ten minutes, she developed bradycardia, hypotension, and ST changes on monitor. Bradycardia and heart block are very common in RCA OMI. In addition to profound acute heart failure, the patient suffered from electrical storm. He told the patient this horrible news. We will never know for certain.
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