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.

Chest Pain 116

Chest Pain Myocardial Infarction STEMI Critical Care 116

Dr. Smith's ECG Blog

MARCH 6, 2023

There was high suspicion of OMI, so patient was brought to critical care area and another ECG was recorded just 7 minutes later as the pain had diminished to 4/10. Here is the repeat ECG at 52 minutes after arrival to triage: Obvious posterolateral STEMI Angiographic findings: 1. Left main: no significant stenosis.

Chest Pain 52

Chest Pain STEMI Stenosis Blog 52

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?

Bradycardia 52

Bradycardia Cardiogenic Shock STEMI Ischemia 52

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

This EKG was recorded as part of a standing order for critical care. 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. An EKG was repeated at 5 minutes The T-wave is less hyperacute. Maybe there is some spontaneous reperfusion?

Chest Pain 52

Chest Pain Coronary Artery Bypass Graft Pericarditis Blog 52

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.

Chest Pain 127

Chest Pain STEMI Stenosis Myocardial Infarction 127

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.

Chest Pain 52

Chest Pain STEMI Myocardial Infarction Coronary Artery Disease 52