Remove Cardiac Arrest Remove Pericarditis Remove STEMI
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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
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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.

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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.

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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.