Electrocardiogram Ischemia Stents 
Dr. Smith's ECG Blog
JANUARY 1, 2013
Precordial ST depression may be subendocardial ischemia or posterior STEMI. I have warned in the past that one must think of other etiologies of ischemia when there is tachycardia. The OM-1 was opened and stented, then the LAD was stented 3 days later. There is no ST elevation. How can we tell the difference?
Dr. Smith's ECG Blog
OCTOBER 28, 2013
STE limited to aVR is due to diffuse subendocardial ischemia, but what of STE in both aVR and V1? The additional ST Elevation in V1 is not usually seen with diffuse subendocardial ischemia, and suggests that something else, like STEMI from LAD occlusion, could be present. Was this: 1) ACS with ischemia and spontaneous reperfusion?
Dr. Smith's ECG Blog
APRIL 18, 2024
Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. But no ECG met STEMI criteria so the patient was referred to cardiology as Non-STEMI. Clin Cardiol 2022 4. McLaren and Smith.
Dr. Smith's ECG Blog
NOVEMBER 15, 2013
The ECG in the chart was read as "no obvious ST changes," (even though no previous ECG was available) and the formal read by the emergency physicians was: "ST deviation and moderated T-wave abnormality, consider lateral ischemia." It was stented. Comment: most T-wave inversion is nonspecific, but not these ones! Gottlieb SO, et al.
EMS 12-Lead
MAY 20, 2022
There is broad subendocardial ischemia as demonstrated by STE aVR with concomitant STD that almost appears appropriately maximal in Leads II and V5. There is LBBB-like morphology with persistent patterns of subendocardial ischemia. A mid-LAD culprit lesion was identified and stented. Pacing Clin Electrophysiol. 40; 1234-1241.
Dr. Smith's ECG Blog
OCTOBER 26, 2011
An open 90% LAD was stented. A 51 year old male with h/o stent presented with 30 minutes of chest pain: Obvious anterolateral very acute STEMI with hyperacute T-waves He went for immediate PCI, with successful reperfusion of a 100% occluded proximal LAD, and a door to balloon time of 35 minutes. The LAD has reperfused early.
Dr. Smith's ECG Blog
FEBRUARY 15, 2018
The patient was then taken to the cath lab an found to have a proximal RCA 100% thrombotic occlusion which was successfully stented. Progression of V2 showing posterior involvement. The QRS-T-angle reflects depolarization–repolarization heterogeneity and might assist in diagnosis and prognosis of patients with suspected NSTEMI.
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