Critical Care Ischemia STEMI 
Dr. Smith's ECG Blog
OCTOBER 26, 2010
He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. At first glance, it seems the patient is having a STEMI. Then ACS (STEMI) might be primary; this might be cardiogenic shock.
Dr. Smith's ECG Blog
MARCH 8, 2021
Prehospital ECG: Obvious anterolateral STEMI (Proximal LAD occlusion) The cath lab was activated prehospital by the medics. Perhaps they indicate an open artery with minimal flow and severe subendocardial ischemia, but not total subepicardial ischemia. Interventionalist at the Receiving Hospital: "No STEMI, no cath.
Dr. Smith's ECG Blog
OCTOBER 6, 2018
We brought the patient into one of our critical care rooms and immediately got more history while recording this repeat ECG: The STE in I has greatly diminished or entirely disappeared. He wrote in his note that "The EKG showed early repolarization in I, V2-V3 but no clear STEMI pattern." We activated the cath lab.
Dr. Smith's ECG Blog
FEBRUARY 15, 2018
Submitted and written by Alex Bracey, with edits by Pendell Meyers and Steve Smith: I was walking through the critical care section of the ED when I overheard a discussion about the following ECG. 3) STEMI criteria failed to identify this acute coronary occlusion, like many others. What do you think?
Dr. Smith's ECG Blog
NOVEMBER 1, 2022
This EKG was recorded as part of a standing order for critical care. 2 days later This is a typical LVH pattern, without ischemia Patient underwent 4 vessel CABG. He had been smoking an opiate and suddenly collapsed. He was ventilated with BVM on arrival. He awoke with naloxone. He denied any CP or SOB.
Dr. Smith's ECG Blog
APRIL 8, 2016
Here is his ED ECG: There is obvious infero-posterior STEMI. What are you worried about in addition to his STEMI? Comments: STEMI with hypokalemia, especially with a long QT, puts the patient at very high risk of Torsades or Ventricular fibrillation (see many references, with abstracts, below). Crit Care Med.
Dr. Smith's ECG Blog
OCTOBER 7, 2019
There is an obvious inferior STEMI, but what else? Besides the obvious inferior STEMI, there is across the precordial leads also, especially in V1. This STE is diagnostic of Right Ventricular STEMI (RV MI). In fact, the STE is widespread, mimicking an anterior STEMI. EKG is pictured below: What do you think?
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