Bradycardia Hypertension STEMI 
Dr. Smith's ECG Blog
MARCH 22, 2024
Written by Willy Frick A man in his 50s with history of hypertension, hyperlipidemia, and a 30 pack-year smoking history presented to the ER with 1 hour of acute onset, severe chest pain and diaphoresis. For national registry purposes, this will be incorrectly classified as a STEMI.) Most STEMI have peak cTnI greater than 10.0.
Dr. Smith's ECG Blog
OCTOBER 9, 2012
A middle-aged woman with a history of hypertension presented with typical chest pain. Her BP was 160/80. Here was her presenting ECG, with chest pain: Inferior leads show hyperacute T-waves and reciprocal STD in aVL, with a reciprocally hyperacute T-wave in aVL. This is all but diagnostic of inferior OMI. There is also subtle STE in V1-V3.
Dr. Smith's ECG Blog
JUNE 19, 2024
Case An 82 year old man with a history of hypertension presented to the ED with chest pain at 1211. Three months prior to this presentation, he received a pacemaker for severe bradycardia and syncope due to sinus node dysfunction. His EKG with worse pain now shows enough ST elevation to meet STEMI criteria.
EMS 12-Lead
MARCH 19, 2023
Vital signs were noted to be unremarkable with respect to any hypo-hypertensive crisis, hypoxia, etc. He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. Fire/EMS crews found him clammy and uncomfortable.
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. NOTE: We do not know how long ago this baseline tracing was done!
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
JUNE 19, 2023
Written by Kaley El-Arab MD, edits by Pendell Meyers and Stephen Smith A 61-year-old male with hypertension and hyperlipidemia presented to the emergency department for chest tightness radiating to the back of his neck that has been intermittent for the past day or two. This ECG was read as “No STEMI” with no prior available for comparison.
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