Dr. Smith's ECG Blog

NOVEMBER 15, 2013

This was a male in his 50's with a history of hypertension and possible diabetes mellitus who presented to the emergency department with a history of squeezing chest pain, lasting 5 minutes at a time, with several episodes over the past couple of months. New ST elevation diagnostic of STEMI [equation value = 25.3 de Wood et al.

Chest Pain 52

Chest Pain Thrombosis Myocardial Infarction STEMI 52

The British Journal of Cardiology

APRIL 16, 2024

Comorbidities included dyslipidaemia 515/567 (90.9%), hypertension 460/567 (81.2%), diabetes 346/567 (61%), known prior coronary disease 250/567 (44.2%), and smoking 188/567 (33.1%).

Outcomes 40

Outcomes Cardiogenic Shock Angina STEMI 40

Dr. Smith's ECG Blog

JUNE 17, 2017

The above is what I thought when I saw this, so I went to the chart and found this history: A type I diabetic aged approximately 35 years old presented with chest pain, nausea, vomiting and diffuse abdominal pain. The possibility of anterior STEMI was not noticed during patient care. pH = 7.17, pCO2 = 24, HCO3 = 8. It was stented.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Stents 52

EMS 12-Lead

MARCH 19, 2023

He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. It doesn’t meet any conventional STEMI criteria, but there is patently obvious increased area under the curve. No appreciable skin pallor.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

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. BP was 110 and oxygen saturation was normal.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

OCTOBER 6, 2018

The patient was in his 50s with history of hypertension, diabetes, seizure disorder, and smoking, but no known coronary artery disease. He wrote in his note that "The EKG showed early repolarization in I, V2-V3 but no clear STEMI pattern." See far below for data on 24 troponin T in STEMI and NSTEMI, and correlation with infarct size.

Chest Pain 40

Chest Pain STEMI Myocardial Infarction Coronary Artery Disease 40

Dr. Smith's ECG Blog

JANUARY 5, 2024

Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." So there is probability of myocardial injury here (and because it is in the correct clinical setting, then myocardial infarction.) The following ECG was obtained.

Angina 121

Angina Plaque Document Stents 121

Dr. Smith's ECG Blog

NOVEMBER 13, 2022

A 50 something-year-old man with a history of newly diagnosed hypertension and diabetes, for which he did not take any medication, presented a non-PCI-capable center with a vague, but central chest pain. The ECG in ER is shown below: ECG is still diagnostic but we are watching the natural course of myocardial infarction here.

Chest Pain 52

Chest Pain Myocardial Infarction Blog Pericarditis 52

Dr. Smith's ECG Blog

APRIL 20, 2018

female with HTN, HLD, diabetes, ESRD on dialysis is brought in by EMS with sudden onset, left -sided chest pain for the past four hours. Given her risk factors (HTN, HLD, ESRD from diabetes) I decided to obtain a broad cardiac workup for the patient: serial ECGs, labs, serial troponins, CXR and bedside cardiac ultrasound.

Chest Pain 40

Chest Pain Ultrasound Risk Factors STEMI 40

Dr. Smith's ECG Blog

SEPTEMBER 21, 2022

A 40-something woman with diabetes and peripheral vascular disease who frequently needs the ED for chronic pain called 911 for sudden severe chest pain. V5-V6) of any amplitude, is specific for Occlusion Myocardial Infarction (vs. The patient was very agitated and could not hold still. non-occlusive ischemia) 2.

Chest Pain 52

Chest Pain Blog Ischemia STEMI 52

Frontiers in Cardiovascular Medicine

JULY 22, 2024

IntroductionIn developing countries, there is a notable scarcity of real-world data on adherence to optimal medical therapy (OMT) and its correlation with major cardiovascular adverse events (MACEs) after ST-elevation myocardial infarction (STEMI). Patients were followed up for 4.5 years (±10.9), predominantly male (89.9%).

Myocardial Infarction 59

Myocardial Infarction Risk Factors Cardiogenic Shock STEMI 59

Open Heart

JULY 17, 2023

Objective This study aimed to examine the association between exercise workload, resting heart rate (RHR), maximum heart rate and the risk of developing ST-segment elevation myocardial infarction (STEMI). Patients with a history of STEMI were excluded. STEMI was adjudicated by the UK Biobank.

Myocardial Infarction 52

Myocardial Infarction STEMI Exercise Blood Pressure 52

Frontiers in Cardiovascular Medicine

JANUARY 15, 2024

The overall prevalence of arterial hypertension was 33.2%, hyperlipidemia, 26.9%, smoking, 17.8%, and diabetes, 3.9%. of the patients were diagnosed with non-ST elevated myocardial infarction (NSTEMI), 36.8% Approximately 48.5%

SCAD 75

SCAD Coronary Artery Bypass Graft Outcomes Myocardial Infarction 75

Dr. Smith's ECG Blog

MAY 8, 2023

Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. Code STEMI was activated by the ED physician based on the diagnostic ECG for LAD OMI in ventricular paced rhythm. I cannot be anything else.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Pacemaker 52

Coronary Artery Disease Journal

NOVEMBER 20, 2023

The primary endpoint was the accumulated target-lesion revascularization rate whereas secondary endpoints consisted of the event rates for major adverse cardiac events (MACE), myocardial infarction, bleeding events and death from all causes. vs. 3.9%; P = 0.020). vs. 5.2%; P = 0.749).

Stents 52

Stents Stent Outcomes Coronary Artery Disease 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury. In normal times, the most common use of cTni is in diagnosing, or ruling out, acute myocardial infarction (AMI, a subcategory of acute myocardial injury.

Cardiac Arrest 52

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock 52

Dr. Smith's ECG Blog

OCTOBER 22, 2024

This was sent to me by a French colleague, Olivier Peyronie "Yesterday we received a 62 yo man with diabetes, hypertension and smoker. Unfortunately, the cardiologist waited until the next day to refer the patient for angiography and intervention because patient did not meet criteria for "STEMI"." This is an enormous posterior infarct!

Chest Pain 66

Chest Pain STEMI Myocardial Infarction Angioplasty 66

Coronary Artery Disease Journal

NOVEMBER 1, 2023

However, the prognostic significance of NPS is unknown in ST-segment elevation myocardial infarction (STEMI). We aimed to analyze the prognostic value of the NPS in-hospital mortality in patients with STEMI. Conclusion The present study demonstrates that the NPS could independently predict in-hospital mortality in STEMI.

Myocardial Infarction 52

Myocardial Infarction Hospital STEMI Cancer 52

Frontiers in Cardiovascular Medicine

DECEMBER 18, 2024

BackgroundAcute myocardial infarction (AMI), particularly ST-segment elevation myocardial infarction (STEMI), significantly impacts global health, exacerbated by risk factors such as diabetes mellitus (DM).

STEMI 52

STEMI Myocardial Infarction Risk Factors Diabetes 52

Dr. Smith's ECG Blog

OCTOBER 30, 2024

ECG #2 Case 2 : The above ECG was obtained from a diabetic 45 year old smoker with chest pain. All of these findings together makes this ECG diagnostic of inferior and posterior occlusion myocardial infarction (OMI) The patient is this case was treated as if he had an ongoing OMI. What do you think? ECG #3 Case 3.

Chest Pain 111

Chest Pain Aortic Myocardial Infarction STEMI 111

Dr. Smith's ECG Blog

OCTOBER 27, 2024

The cath lab was deactivated by cardiologist on arrival at ED because it was "not a STEMI". He carries the diagnoses hyperlipidemia, hypertension, and diabetes. Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients.

STEMI 121

STEMI Chest Pain Myocardial Infarction Aneurysm 121

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

Smith: T waves are very hyperacute: these are a sign of ACUTE infarction, even if there are Q-waves. 50% of LAD STEMI have Q-waves by one hour. Smith : In limb leads, the ST vector is towards lead II (STE lead II STE lead III, which is more likely with pericarditis than with STEMI). See Raitt et al.:

Chest Pain 88

Chest Pain Pericarditis Myocardial Infarction Dementia 88

Open Heart

JANUARY 4, 2025

We aim to investigate the influence of sex on the timing and clinical outcomes of ST-segment elevation myocardial infarction (STEMI) patients using a controlled Swiss registry. Men had higher rates of diabetes, smoking and dyslipidaemia, while women had higher hypertension and renal insufficiency rates.

Myocardial Infarction 40

Myocardial Infarction STEMI Coronary Artery Disease Outcomes 40