Circulation Electrocardiogram Ischemia 
Dr. Smith's ECG Blog
JANUARY 1, 2013
Precordial ST depression may be subendocardial ischemia or posterior STEMI. I have warned in the past that one must think of other etiologies of ischemia when there is tachycardia. Whether it is subendocardial ischemia or posterior STEMI, if you cannot get it to resolve, you must activate the cath lab. There is no ST elevation.
Dr. Smith's ECG Blog
JANUARY 1, 2024
An initial electrocardiogram (ECG) is provided below. Learning Point: Concordant ST segment elevation can arise from profound ischemia triggered by ventricular tachycardia (VT), or it may represent an exaggerated basal ST change accompanying tachycardia. The patient was promptly admitted to the hospital for further evaluation.
Dr. Smith's ECG Blog
APRIL 18, 2024
5] Back to the case The patient had serial ECGs over the next hour with no significant change: The first troponin came back at 1,400 ng/L (normal <26 in males and <16 in females), confirming MI – and the patient’s refractory ischemia indicated this was an Occlusion MI. Circulation 2014 2. link] References 1. Amsterdam et al.
Dr. Smith's ECG Blog
NOVEMBER 15, 2013
The ECG in the chart was read as "no obvious ST changes," (even though no previous ECG was available) and the formal read by the emergency physicians was: "ST deviation and moderated T-wave abnormality, consider lateral ischemia." Circulation 1991;84:1454-1455. Comment: most T-wave inversion is nonspecific, but not these ones!
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 26, 2011
The patient continued to have ischemia after PCI, and in fact had an episode of polymorphic VT shortly after while in the ICU. Circulation 1999;99(15):1972-7. Circulation 2000;101(2):125-30. Clinical value of 12-lead electrocardiogram after successful reperfusion therapy for acute myocardial infarction.
Dr. Smith's ECG Blog
DECEMBER 5, 2022
Electromechanical association: a subtle electrocardiogram artifact. Incredibly , this case was just published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) link] Circulation. link] Circulation. Journal of Electrocardiology. 2012;45(1):15-17. doi:10.1016/j.jelectrocard.2010.12.162.
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