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
SEPTEMBER 3, 2023
He reports that this chest pain feels different than prior chest pain when he had his STEMI/OMI, but is unable to further describe chest pain. Sensitivity was 87% for OMI in our validation study (it was 34% for STEMI criteria). He reports feeling nauseated with emesis. The Queen was not used in real time. Even the Queen can be wrong.
Dr. Smith's ECG Blog
JULY 23, 2024
I took the patient to the critical care area and questioned him more on the way. Another ECG was recorded while awaiting the cath team: Now there is STEMI Let's look at that first (prehospital ECG) again: Very subtle! The pain had been intermittent until an hour before arrival, when he called 911. We activated the cath lab.
Dr. Smith's ECG Blog
SEPTEMBER 1, 2023
It was tested on a large database of known outcomes and was more than twice as senstivity as STEMI criteria and much better than cardiologists. The patient was moved to the critical care area (stabilization room). This is the first version of the AI system. Accuracy was 91% and AUC was 0.95. Cath lab was activated.
Dr. Smith's ECG Blog
SEPTEMBER 7, 2024
Smith : there is some minimal ST elevation in V2-V6, but does not meet STEMI criteria. Transient STEMI has been studied and many of these patients will re-occlude in the middle of the night. Is it normal STE? The computer thinks so, and the physician thinks that is quite possible. However , there is terminal QRS distortion in lead V3.
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.
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