Dr. Smith's ECG Blog
DECEMBER 26, 2020
Is this inferor STEMI? Atrial Flutter with Inferior STEMI? Inferolateral ST elevation, vomiting, and elevated troponin The treating team did not identify the flutter waves and they became worried about possible "STEMI" (despite the unusual clinical scenario). The EM provider asked if the cardiologist thought it was a "STEMI."
Dr. Smith's ECG Blog
MAY 27, 2012
In other words, after reperfusion therapy for STEMI, the appearance of AIVR is usually a good sign, meaning that the artery is reperfused. The second explanation (AIVR), whether as a reperfusion dysrhythmia or not, seems most likely. In fact, there may be less than 1 mm of concordant ST depression in lead V3. But it is not conclusive.
Dr. Smith's ECG Blog
JUNE 14, 2017
Accelerated idioventricular rhythm in newborns: a worrisome but benign entity with or without congenital heart disease Here are other examples of Accelerated Idioventricular Rhythm, Usually a Reperfusion "Dysrhythmia" I saw this on the computer. Is there STEMI? Most physicians, at first glance, get this wrong. What is it?
Dr. Smith's ECG Blog
NOVEMBER 30, 2019
to greatly decrease risk (although in STEMI, the optimal level is about 4.0-4.5 I could find very little literature on the treatment of severe life-threatening hypokalemia. There is particularly little on how to treat when the K is less than 2, and/or in the presence of acute MI. If the patient is at 1.8, that will raise it to 5.1
Dr. Smith's ECG Blog
JULY 31, 2018
It is equivalent to a transient STEMI. Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. If you would not have activated the cath lab based on the first ECG, you really should strongly think about it now. Again, cath lab was not activated.
Dr. Smith's ECG Blog
JULY 22, 2023
A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. There were no dysrhythmias on cardiac monitor during observation. So maybe she is better than I am. He was found to be influenza positive. Is there fever again?
Dr. Smith's ECG Blog
JANUARY 30, 2019
2) The STE in V1 and V2 has an R'-wave and downsloping ST segments, very atypical for STEMI. Cardiology was consulted and they agreed that the EKG had an atypical morphology for STEMI and did not activate the cath lab. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Bicarb 20, Lactate 4.2,
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