Remove Cardiac Arrest Remove Pericarditis Remove STEMI
article thumbnail

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

He had multiple cardiac arrests with ROSC regained each time. Dyspnea, Chest pain, Tachypneic, Ill appearing: Bedside Cardiac Echo gives the Diagnosis 31 Year Old Male with RUQ Pain and a History of Pericarditis. Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism.

article thumbnail

Inferior ST Elevation: what is the Diagnosis?

Dr. Smith's ECG Blog

T-wave to ST ratio is greater than 4 in lead V6, making pericarditis unlikely (also there were no symptoms of pericarditis). If there are no changes in aVL, it is highly unlikely to be inferior STEMI. Would you be certain that it is not STEMI? Sudden cardiac arrest associated with early repolarization.

article thumbnail

Cardiologist declines taking patient to the cath lab. Patient dies.

Dr. Smith's ECG Blog

As always, takotsubo cardiomyopathy and focal pericarditis can mimic OMI, but takotsubo almost never mimics posterior MI, and both are diagnoses of exclusion after a negative cath. The provider contacted cardiology to discuss the case, but cardiology "didn't think it was a STEMI, didn't think he needed emergent cath." Canto et al.

article thumbnail

Cardiac Arrest, hypotension, tachycardia

Dr. Smith's ECG Blog

There is ST depression in II, III, and aVF that is concerning for reciprocal depression from high lateral STEMI in aVL, where there is some ST elevation. There is also ST depression in precordial leads, greatest in V3 and V4, concerning for posterior STEMI. The patient died is spite of resuscitative efforts. It is found on 1% to 3.5%

article thumbnail

Chest pain and hypotension in a patient who is 3 weeks post STEMI

Dr. Smith's ECG Blog

A middle aged patient who was 3 weeks s/p STEMI came from cardiac rehab where he developed some chest pain, dyspnea and weakness on the treadmill. There is no acute STEMI. This is diagnostic of recent, reperfused STEMI. This is diagnostic of recent, reperfused STEMI. Acute STEMI would have upright T-waves.

article thumbnail

Unconscious + STEMI criteria: activate the cath lab?

Dr. Smith's ECG Blog

ECG met STEMI criteria and was labeled STEMI by computer interpretation. J waves can also be induced by Occlusion MI (5), STEMI mimics including takotsubo and myocarditis complicated by ventricular arrhythmias (6, 7), and subarachnoid hemorrhage with VF (8). Take home : Not all STEs are STEMIs or OMIs. What do you think?

STEMI 52