Diabetes Ischemia STEMI 
Dr. Smith's ECG Blog
NOVEMBER 22, 2023
Pulse was 115, BP 140/65, and afebrile He was found to have cellulitis and to be in diabetic ketoacidosis, with bicarb of 14, pH of 2.27, glucose of 381, anion gap of 18, and lactate of 2.2 Important point: when there is diffuse subendocardial ischemia but no OMI, a wall motion abnormality will not necessarily be present.
Dr. Smith's ECG Blog
OCTOBER 26, 2011
This 57 yo diabetic male presented with generalized fatigue, myalgias, and arthralgias , mild subjective fever and chills, and nausea. This 42 yo diabetic male presented with cough and foot pain. The patient continued to have ischemia after PCI, and in fact had an episode of polymorphic VT shortly after while in the ICU.
Dr. Smith's ECG Blog
AUGUST 19, 2023
Written by Jesse McLaren A 75 year-old patient with diabetes and end stage renal disease was sent to the ED after dialysis for three days of nausea, vomiting, loose stool, lightheadedness and fatigue. They were less likely to have STEMI on ECG, and more likely to be initially diagnosed as non-ACS. RR18 sat 99% HR 90 BP 90/60, afebrile.
Dr. Smith's ECG Blog
AUGUST 30, 2020
This ECG was texted to me with the message "A 31 year old with Diabetes and HTN complains of bilateral arm tingling and headache." The computer calls it a STEMI. See this case of Type 2 STEMI due to severe hypertension. Here are more Type II STEMI. Any ECG finding that is a manifestation of ischemia will change over time.
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
Case submitted and written by Mazen El-Baba MD, with edits from Jesse McLaren and edits/comments by Smith and Grauer A 90-year old with a past medical history of atrial fibrillation, type-2 diabetes, hypertension, dyslipidemia, presented with acute onset chest/epigastric pain, nausea, and vomiting. His response: “subendocardial ischemia.
Dr. Smith's ECG Blog
SEPTEMBER 5, 2024
It has been estimated that in the aggregate, they occur at a rate of about 3 per 1000 patients with acute MI, and most of these events occur in patients with STEMI. A mong patients with STEMI, ventricular septal rupture is the most common and free wall rupture is the least common.
Dr. Smith's ECG Blog
FEBRUARY 1, 2023
Written by Jesse McLaren, with edits from Smith A 30 year old with a history of diabetes presented with two days of intermittent chest pain and diaphoresis, which recurred two hours prior to presentation. It was signed off by an emergency physician as “STEMI negative” because it did not meet STEMI criteria.
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