Coronary Angiogram Pulmonary STEMI 
Dr. Smith's ECG Blog
MAY 10, 2023
A CT Coronary angiogram was ordered. Here are the results: --Minimally obstructive coronary artery disease. --LAD No signs for aortic dissection or pulmonary embolus. --"Results were discussed with the ordering physician. Thus, Wellens' syndrome should be thought of as a transient OMI or transient STEMI.
Dr. Smith's ECG Blog
MAY 30, 2024
Will you accept this patient for emergent coronary angiogram based on the ECG changes? Does the ECG represent STEMI-negative OMI findings? You too can have the Queen of Hearts AI model Learning points: The ECG often can give clues to pulmonary disease Atrial repolarization wave (Ta wave) can mimic ischemia.
Dr. Smith's ECG Blog
MAY 20, 2024
In SCAPE (sympathetic crashing acute pulmonary edema), Emergency providers seem now to regularly give high dose NTG, but when the BP is 170/105 in a patient who is not crashing, we often fail to give something to lower afterload. __ Here are some Images: The red circle shows the LAD coursing down the anterior interventricular sulcus.
Dr. Smith's ECG Blog
JUNE 20, 2020
The medics were worried about STEMI, as it meets STEMI criteria. Discussion Thus, no further ECGs were recorded and there was no angiogram or stress test or CT coronary angiogram. The troponins are NOT consistent with STEMI (OMI), which typically has a troponin I of at least 5 ng/mL. What do you think?
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
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.
Dr. Smith's ECG Blog
DECEMBER 22, 2022
On his physical examination, cardiac and pulmonary auscultation was completely normal. Bi-phasic scan showed no dissection or pulmonary embolism. Coronary arteries cannot be assessed because the scan was not gated, but proximal segments of the coronary arteries seem to be open with some contrast. Turk Kardiyol Dern Ars.
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. CT angiogram chest: no aortic dissection or pulmonary embolism. 24 yo woman with chest pain: Is this STEMI?
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