Remove Dysrhythmia Remove Pulmonary Remove Thrombosis
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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

As in all ischemia interpretations with OMI findings, the findings can be due to type 1 AMI (example: acute coronary plaque rupture and thrombosis) or type 2 AMI (with or without fixed CAD, with severe regional supply/demand mismatch essentially equaling zero blood flow). CT angiogram showed extensive saddle pulmonary embolism.

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Syncope and ST Elevation on the Prehospital ECG

Dr. Smith's ECG Blog

He was admitted for monitoring, as his risk of a ventricular dysrhythmia as cause of the syncope is high ( very high due to HFrEF and ischemic cardiomyopathy ). Nevertheless, I don't think a thrombosis related type I MI was ruled out here simply because the patient refused further evaluation. The ECG is simply not optimally accurate.

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