European Journal of Heart Failure

OCTOBER 30, 2023

CMR, cardiac magnetic resonance; LV, left ventricular; LVEDVi, left ventricular end-diastolic volume index; LVEF, left ventricular ejection fraction; LVESVi, left ventricular end-systolic volume index; MI, myocardial infarction; pPCI, primary percutaneous coronary intervention; SE, standard error; STEMI, ST-elevation myocardial infarction.

Myocardial Infarction 40

Myocardial Infarction STEMI Angioplasty Research 40

Dr. Smith's ECG Blog

JUNE 27, 2021

The patient has heart failure as a result of this event. Angiogram: "ACS - Non ST Elevation Myocardial Infarction. This is a HUGE myocardial infarction. How could an occlusion (Occlusion MI, OMI) that results in the loss of a massive amount of myocardium and results in Heart Failure be missed?

Myocardial Infarction 40

Myocardial Infarction Ischemia STEMI Pulmonary 40

Dr. Smith's ECG Blog

MAY 20, 2024

Smith comment 2: I frequently see failure to control BP in patients with acute chest pain or acute heart failure. The Queen of Hearts once again diagnoses OMI with high confidence: The ED provider recognized the changes in this EKG and called cardiology for a STAT consult. Murakami MM.

Chest Pain 124

Chest Pain Blood Pressure Ischemia STEMI 124

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

DECEMBER 14, 2016

ng/mL (ULN = 0.030 ng/mL) , diagnostic of myocardial injury. The "criteria" for posterior STEMI are 0.5 The elevated troponin is diagnostic of myocardial injury. There was a normal creatinine and no evidence of heart failure and no other reason for chronic injury, so it must be acute. Is it STEMI or NonSTEMI?

Chest Pain 52

Chest Pain STEMI Aortic Myocardial Infarction 52

Dr. Smith's ECG Blog

AUGUST 6, 2024

The ECG is diagnostic of occlusion myocardial infarction (OMI). It definitely does not fulfill STEMI criteria, and I would argue that it would not lead to cath lab activation in most centers. The Queen Of Hearts app is an excellent tool to assist in expediting cardiac cath and emergent revascularization in the cath lab!

Chest Pain 103

Chest Pain Ischemia Pericarditis Tachycardia 103

EMS 12-Lead

MAY 20, 2022

This worried the crew of potential acute coronary syndrome and STEMI was activated pre-hospital. When OMI is captured in this early phase, there exists the highest amount of salvageable myocardium and least likelihood of heart failure at hospital discharge. Smith comment : V5 and V6 are excessively discordant!!!! 40; 1234-1241.

Cardiomyopathy 52

Cardiomyopathy Ischemia STEMI Coronary Angiogram 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Clinical Course The paramedic activated a “Code STEMI” alert and transported the patient nearly 50 miles to the closest tertiary medical center. 2 The astute paramedic recognized this possibility and announced a CODE STEMI. myocardial infarction), arrhythmias, valvular pathology, shunts, or outflow obstructions.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

Dr. Smith's ECG Blog

FEBRUARY 15, 2018

100% occluded RCA with TIMI 0 flow Post drug-eluting stent placement with TIMI 3 flow While in the cath lab, she transiently developed complete heart block and became hypotensive requiring transvenous pacemaker placement and transient pressors. 3) STEMI criteria failed to identify this acute coronary occlusion, like many others.

Chest Pain 52

Chest Pain Critical Care Article Pacemaker 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

Dr. Smith's ECG Blog

APRIL 8, 2016

Here is his ED ECG: There is obvious infero-posterior STEMI. What are you worried about in addition to his STEMI? Comments: STEMI with hypokalemia, especially with a long QT, puts the patient at very high risk of Torsades or Ventricular fibrillation (see many references, with abstracts, below). There is atrial fibrillation.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Frontiers in Cardiovascular Medicine

JANUARY 22, 2024

Background Women are more likely to develop heart failure (HF) after myocardial infarction. Methods The patients with PPCI-treated anterior STEMI, from the CIRCUS study cohort, were followed up for 1 year and HF events were recorded. The infarct size and LVEF were similar between the sexes.

Myocardial Infarction 64

Myocardial Infarction Heart Failure STEMI Hypertension 64

Circulation

NOVEMBER 11, 2024

This study investigates the relationship between baseline 5-HTP levels and the incidence of major adverse cardiovascular events (MACE) in patients who have experienced ST-elevation myocardial infarction (STEMI).Objective:Our years, 53 women) followed for up to 15 years.

Myocardial Infarction 40

Myocardial Infarction Coronary Artery Bypass Graft STEMI Angina 40

Journal of Cardiovascular Pharmacology

NOVEMBER 11, 2024

Patients with ST-segment elevation myocardial infarction (STEMI) and complex coronary artery disease (CAD) face a poor prognosis, including increased heart failure (HF) risk. We performed a pooled secondary analysis of 139 patients with STEMI.

Coronary Artery Disease 40

Coronary Artery Disease Myocardial Infarction STEMI Heart Failure 40

Frontiers in Cardiovascular Medicine

JANUARY 15, 2024

The outcomes of interest were all-cause death and major adverse cardiovascular events (MACE), including acute coronary syndrome (ACS), heart failure (HF), need for additional revascularization, target vessel revascularization (TVR), SCAD recurrence, and stroke. Approximately 48.5%

SCAD 75

SCAD Coronary Artery Bypass Graft Outcomes Myocardial Infarction 75

Circulation: Cardiovascular Imaging

MARCH 24, 2025

BACKGROUND:T2-weighted imaging is commonly used to measure myocardial salvage in reperfused myocardial infarction but is hindered by poor reproducibility and indistinct boundaries. The median MSI was 35.0% (interquartile range, 22.959.5%), with smaller MSI observed in patients with larger infarcts (P<0.001).

Myocardial Infarction 40

Myocardial Infarction STEMI Thrombolysis Cardiovascular Imaging 40

Circulation: Cardiovascular Interventions

FEBRUARY 20, 2024

BACKGROUND:Patients with ST-segment–elevation myocardial infarction but no coronary microvascular injury are at low risk of early cardiovascular complications (ECC). CONCLUSIONS:NH-IMRangiois a valuable risk-stratification tool in patients with ST-segment–elevation myocardial infarction.

Myocardial Infarction 40

Myocardial Infarction STEMI Cardiogenic Shock Cardiac Arrest 40

Dr. Smith's ECG Blog

OCTOBER 24, 2018

This is all but diagnostic of STEMI, probably due to wraparound LAD The cath lab was activated. Therefore, this does not meet the definition of myocardial infarction ( 4th Universal Definition of MI ), which requires at least one troponin above the 99% reference range. No further troponins were drawn. Why is this important?

STEMI 40

STEMI Angina Myocardial Infarction Plaque 40

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 9, 2018

The utility of the triage electrocardiogram for the detection of ST-segment elevation myocardial infarction. link] In this paper, in a department in which they state they have only 50 STEMI per year, they looked at only 8 days worth of triage ECGs for a total of 538. They did not find one STEMI on their triage ECGs (no surprise!

Chest Pain 52

Chest Pain STEMI Cardiac Arrest Blog 52

Dr. Smith's ECG Blog

OCTOBER 13, 2023

There is worrisome T-wave inversion in inferior leads as well, which is another clue to LAD Occlusion In fact, this ECG meets STEMI criteria!! Why does the conventional algorithm not diagnose STEMI? Transient STEMI, serial ECGs prehospital to hospital, all troponins negative (less than 0.04 Learning Points: 1.

Chest Pain 115

Chest Pain STEMI Cardiac Arrest Myocardial Infarction 115

Dr. Smith's ECG Blog

MARCH 19, 2025

Heres the Queen of Hearts interpretation, drawing attention especially to III and aVL: This patient does indeed need emergent intervention. STEMI criteria are only 43% sensitive for OMI. They end up with high mortality and needless heart failure. Beware confusing the diagnosis of posterior STEMI by using posterior leads.

Chest Pain 115

Chest Pain STEMI Stents Stent 115

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

Dr. Smith's ECG Blog

MARCH 8, 2025

The authors describe a case with some features in common with our patient -- a stressful event followed by a stress cardiomyopathy/acute myocardial infarction overlap syndrome. In addition to profound acute heart failure, the patient suffered from electrical storm. Journal of the American Heart Association , 8 (9).

Cardiomyopathy 74

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 74