Coronary Angiogram Outcomes STEMI 
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
Post cath ECG: Now there are hyperacute T-waves again, and recurrent ST depression in V2 This ECG would normally diagnostic of OMI until proven otherwise No further troponins were measured, but it looks like there is recurrent OMI Next day: A CT Coronary Angiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. IMPRESSION: 1.
Dr. S. Venkatesan MD
JUNE 26, 2024
We know, how adverse is the outcome of Left main STEMI. Left Main Coronary Artery Atresia: Diagnostic Images of a Rare Coronary Anomaly. In reality, there could be thousands of asymptomatic ones in the public domain. it can result in both risky as well as protective events. Reference Yassin AS, Dayco J, Kottam A.
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. aVR ST segment elevation: acute STEMI or not? Incidence of an acute coronary occlusion.
EMS 12-Lead
MARCH 19, 2023
It doesn’t meet any conventional STEMI criteria, but there is patently obvious increased area under the curve. Could there have been a different outcome if the crews immediately recognized OMI – versus a shortened PR-interval – and commenced with pre-hospital Cath Lab activation? Is this OMI?
Dr. Smith's ECG Blog
MAY 16, 2023
Here is the Queen of Heart's interpretation: The cath lab had been activated for concern of STEMI. No angiogram was performed. Other outcome information is not available. Learning Points: This is one of many examples of false positive STEMI criteria, which is distinguishable by expert humans, and now by AI such as QOH.
Dr. Smith's ECG Blog
JANUARY 9, 2023
50% of LAD STEMIs do not have reciprocal findings in inferior leads, and many LAD OMIs instead have STE and/or HATWs in inferior leads instead. The ECG easily meets STEMI criteria in all leads V2-V6, as well. 24 yo woman with chest pain: Is this STEMI? This is not "diffuse", this is simply anterior, lateral, and likely apical.
Dr. Smith's ECG Blog
MARCH 3, 2025
Supply-demand mismatch can cause ST Elevation (Type 2 STEMI). Also see these posts of Type II STEMI. An EKG from a year prior was available for comparison: The ED physician noted Initial EKG here read by the computer as a STEMI, however, there is a very poor baseline and a lot of artifact. See reference and discussion below.
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