Remove Cardiogenic Shock Remove Electrocardiogram Remove Myocardial Infarction
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A man in his 70s with acute chest pain and paced rhythm.

Dr. Smith's ECG Blog

Diagnosis of Acute Myocardial Infarction in the Presence of Left Bundle Branch Block using the ST Elevation to S-Wave Ratio in a Modified Sgarbossa Rule. Electrocardiographic Diagnosis of Acute Coronary Occlusion Myocardial Infarction in Ventricular Paced Rhythm Using the Modified Sgarbossa Criteria.

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How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. Widimsky P et al.

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Chest pain and shock: Is there a right ventricular OMI on this ECG? And should he undergo trancutaneous pacing?

Dr. Smith's ECG Blog

Literature cited In inferior myocardial infarction, neither ST elevation in lead V1 nor ST depression in lead I are reliable findings for the diagnosis of right ventricular infarction Johanna E. A 12-lead electrocardiogram, lead V4R , and leads V7-9 were recorded on admission. Such an escape would have a wider complex.

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Should Troponin be a Vital Sign? Perhaps, but only if Interpreted Using Pre-test Probability.

Dr. Smith's ECG Blog

LAD 80% mid LCx occluded mid (acute infarct lesion) RCA 80% mid. PCI mid LCx So this is an OMI (Occlusion Myocardial Infarction), but not a STEMI Echo: Decreased left ventricular systolic performance, mild/moderate. The patient went into cardiogenic shock and ultimately died of this MI. The cath lab was activated.

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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. Incidence of an acute coronary occlusion. Am J Med 2019, 132(5):622-630. Left main?