Remove Coronary Angiogram Remove Dysrhythmia Remove STEMI
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Syncope and ST Elevation on the Prehospital ECG

Dr. Smith's ECG Blog

The medics were worried about STEMI, as it meets STEMI criteria. He was admitted for monitoring, as his risk of a ventricular dysrhythmia as cause of the syncope is high ( very high due to HFrEF and ischemic cardiomyopathy ). The troponins are NOT consistent with STEMI (OMI), which typically has a troponin I of at least 5 ng/mL.

STEMI 52
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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

Clinical Course The paramedic activated a “Code STEMI” alert and transported the patient nearly 50 miles to the closest tertiary medical center. The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve. Look at the aortic outflow tract.