Cardiovascular Interventions Chest Pain STEMI 
Dr. Smith's ECG Blog
OCTOBER 24, 2019
[link] A 30 year-old woman was brought to the ED with chest pain. She had given birth a week ago, and she had similar chest pain during her labor. She attributed the chest pain to anxiety and stress, saying "I'm just an anxious person." examined SCAD presenting as STEMI (unlike Hassan et al.
Dr. Smith's ECG Blog
AUGUST 3, 2017
A 70-year-old man calls 911 after experiencing sudden, severe chest pain. The precordial ST-depression pattern on this ECG (and in this clinical setting) should immediately raise suspicion of Posterior STEMI! But if there is none - then you are looking at least at an Isolated Posterior STEMI until proven otherwise.
Dr. Smith's ECG Blog
DECEMBER 11, 2023
Recall from this post referencing this study that "reciprocal STD in aVL is highly sensitive for inferior OMI (far better than STEMI criteria) and excludes pericarditis, but is not specific for OMI." See this case: Persistent Chest Pain, an Elevated Troponin, and a Normal ECG. JACC: Cardiovascular Interventions , 9 (6), 541–549.
Dr. Smith's ECG Blog
JUNE 18, 2013
This was my thought: if this patient presented to the ED with chest pain, then this is an LAD occlusion. His ECG was repeated at this point: This shows a well developed anterior STEMI. To not see these findings is very common, and this patient would be given the diagnosis of NonSTEMI, with subsequent development of STEMI.
Dr. Smith's ECG Blog
JANUARY 24, 2025
The patient received three nitroglycerin tablets with significant "improvement" in his chest pain. Improved chest pain is unresolved chest pain. I am commonly told, and I commonly read in the chart that chest pain is resolved. It is not enough for the chest pain to be "much better."
Dr. Smith's ECG Blog
MARCH 17, 2025
Written by Willy Frick A man in his 60s with a history of hypertension and 40 pack-year history presented to the ER with 1 day of intermittent, burning substernal chest pain radiating into both arms as well as his back and jaw. In the world of STEMI, we are incapable of recognizing the first ECG as a false negative.
Dr. Smith's ECG Blog
MARCH 8, 2025
He had no chest pain, dyspnea, or any other anginal equivalent, and his vital signs were normal. Catheterization and Cardiovascular Interventions , 82 (6), 909913. There was indication of parasympathetic overdrive ( the acute inferior STEMI with profound bradycardia and junctional escape ). SanzRuiz, R.,
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