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
DECEMBER 16, 2024
She had this ECG recorded: Obvious massive anterior STEMI She was quickly brought to the critical care area and the cath lab was activated. The blood pressure was 170/100 in the critical care area. Here is the ECG at 25 minutes: Terrible LAD STEMI (+) OMI So a CT scan was done which of course showed a normal aorta.
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?
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
MAY 5, 2022
Despite the clinical context, Cardiology was consulted due to concerns for a "STEMI". It is critically important for all EM and critical care providers to have an intimate understanding of hyperkalemia and its ECG findings. From Ken Grauer ( See below ) — with this Figure adapted from LITFL.
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.
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