Dr. Smith's ECG Blog

NOVEMBER 30, 2019

If cardiac arrest from hypokalemia is imminent (i.e., to greatly decrease risk (although in STEMI, the optimal level is about 4.0-4.5 mEq of K pushed fast and circulated theoretically would raise serum K immediately by 1.0 As I indicated above, in our cardiac arrest case, after pushing 40 mEq, the K only went up to 4.2

Cardiac Arrest 40

Cardiac Arrest Tachycardia Nursing Ultrasound 40

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

It is apparently fortunate that she had a cardiac arrest; otherwise, her ECG would have been ignored. Then they did an MRI: Patient underwent cardiac MRI on 10/4 that showed mildly reduced BiV systolic function. This has resulted in an under-representation of STEMI MINOCA patients in the literature. From Gue at al.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

JUNE 27, 2024

A patient had a cardiac arrest with ventricular fibrillation and was successfully defibrillated. COACT: The COACT trial was fatally flawed, and because of it, many cardiologists are convinced that if there are no STEMI criteria, the patient does not need to go to the cath lab. These studies did not address OMI ECG findings!!!

Defibrillator 113

Defibrillator Cardiac Arrest STEMI Chest Pain 113

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? Comments: STEMI with hypokalemia, especially with a long QT, puts the patient at very high risk of Torsades or Ventricular fibrillation (see many references, with abstracts, below). There is atrial fibrillation.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

OCTOBER 20, 2013

Note that they finally have laid to rest the new or presumably new LBBB as a criteria for STEMI. Note that they finally have laid to rest the new or presumably new LBBB as a criteria for STEMI. Also note that they allow ST depression c/w posterior MI to be a STEMI equivalent. What is the utility of a head CT in cardiac arrest?

Cardiac Arrest 52

Cardiac Arrest STEMI Hemorrhage Hospital 52

Circulation: Cardiovascular Interventions

FEBRUARY 20, 2024

Circulation: Cardiovascular Interventions, Ahead of Print. BACKGROUND:Patients with ST-segment–elevation myocardial infarction but no coronary microvascular injury are at low risk of early cardiovascular complications (ECC).

Myocardial Infarction 40

Myocardial Infarction STEMI Cardiogenic Shock Cardiac Arrest 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2014

Here are three more dramatic cases that illustrate RBBB + LAFB Case 1 of cardiac arrest with unrecognized STEMI, died. Furthermore, among 35 patients with acute left main coronary artery occlusion, 9 presented with RBBB (mostly with LAH) on the admission ECG.

Chest Pain 52

Chest Pain Cardiac Arrest Myocardial Infarction Angioplasty 52

Dr. Smith's ECG Blog

JULY 21, 2024

The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. The below ECG was recorded.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

It may be difficult to read STEMI in the setting of RBBB. There is, however, a long QT also, with abnormal T-waves, but this is not STEMI. This ECG was recorded prehospital, and the computer read STEMI, so the medics activated the cath lab: What do you think? The ECG is consistent with high lateral STEMI. Called 911.

STEMI 40

STEMI Chest Pain Cardiac Arrest Stents 40

Dr. Smith's ECG Blog

JULY 22, 2023

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. Circulation, 117, 1890–1893. [3]: So maybe she is better than I am. Smith comment: the ECG in question could be due to Brugada, even though there is a change from baseline.

Chest Pain 92

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 92

Dr. Smith's ECG Blog

JANUARY 30, 2019

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. Circulation, 117, 1890–1893. [3]: See additional image at the bottom of this post. Bicarb 20, Lactate 4.2,

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Frontiers in Cardiovascular Medicine

JANUARY 8, 2025

AimThis study aimed to protect brain functions in patients who experienced in-hospital cardiac arrest through the application of local cerebral hypothermia. underwent emergency coronary angiography due to ST-elevation myocardial infarction (STEMI). Among the patients, 62.5%

Cardiac Arrest 52

Cardiac Arrest Myocardial Infarction Blood Pressure Hospital 52

Dr. Smith's ECG Blog

APRIL 9, 2025

The paramedics diagnosis was "Possible Anterolateral STEMI." More proof that a huge STEMI may have normal or near normal initial troponin. A retrospective 'target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. The final angiographic result is very good.

Defibrillator 63

Defibrillator Cardiac Arrest Myocardial Infarction STEMI 63