Cardiovascular Interventions Ischemia STEMI 
Dr. Smith's ECG Blog
AUGUST 3, 2017
Computer read: "Non-specific ST abnormality, consider anterior subendocardial ischemia" There are very poor R-waves in V1-V4 suggesting old anterior MI. Firstly, subendocardial ischemia does not localize on 12-Lead ECG. But the real question at hand is: Are these precordial ST-depressions a result of subendocardial ischemia?
Dr. Smith's ECG Blog
OCTOBER 24, 2019
This strongly suggests reperfusing RCA ischemia. Troponins, echocardiogram An echocardiogram showed inferobasilar hypokinesis, further supporting a diagnosis of regional ischemia , likely of the area supplied by the RCA. A recent study found that SCAD causes almost 20% of STEMI in young women. There is also a Q-wave in III.
Dr. Smith's ECG Blog
JANUARY 24, 2025
Severe ischemia can be present even when the chest pain is gone. Learning points: 40% of LAD OMI with TIMI-0 flow do NOT meet STEMI criteria (manuscript under consideration at Eur Ht. J Cardiovascular Interventions.--20/53 The CLINICIAN is the historian.) Smith : Even resolution of symptoms is not enough. See this case.
Dr. Smith's ECG Blog
MARCH 8, 2025
It is possible there is microvascular dysfunction producing residual transmural ischemia. But this is most common when there is prolonged ischemia, and this patient had the fastest reperfusion imaginable! Catheterization and Cardiovascular Interventions , 82 (6), 909913. SanzRuiz, R., Solis, J., & link] Bai, J.,
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