Hemorrhage STEMI Tachycardia 
Dr. Smith's ECG Blog
OCTOBER 26, 2010
He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. At first glance, it seems the patient is having a STEMI. Then ACS (STEMI) might be primary; this might be cardiogenic shock.
Dr. Smith's ECG Blog
DECEMBER 20, 2010
This is the ECG of a 50 yo old woman who collapsed, was found to have a pulse, but then found to be in ventricular tachycardia. The cath lab was activated for STEMI, but the patient had clean coronaries. Before initiating therapeutic hypothermia, a head CT was done and showed fatal subarachnoid hemorrhage.
Dr. Smith's ECG Blog
DECEMBER 26, 2020
Side note: The differential of sudden persistent loss of consciousness with adequate hemodynamics is relatively short: seizure, intracranial hemorrhage, basilar artery occlusion. Is this inferor STEMI? Tachycardia and ST Elevation. Atrial Flutter with Inferior STEMI? There was again no intracranial hemorrhage.
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. aVR ST segment elevation: acute STEMI or not? aVR ST Segment Elevation: Acute STEMI or Not?
Dr. Smith's ECG Blog
AUGUST 9, 2024
Automatic activity refers to enhanced pacemaking function (typically from a non sinus node source), for example atrial tachycardia. The receiving emergency physician consulted with interventional cardiology who stated there was no STEMI. Is there STEMI? The patient continued having chest pain. Leave it alone. Bigger et al.
Dr. Smith's ECG Blog
AUGUST 9, 2019
When total LM occlusion does present with STE in aVR, there is ALWAYS ST Elevation elsewhere which makes STEMI obvious; in other words, STE is never limited to only aVR but instead it is part of a massive and usually obvious STEMI. All are, however, clearly massive STEMI. This is her ECG: An obvious STEMI, but which artery?
Dr. Smith's ECG Blog
FEBRUARY 20, 2025
A 12-lead was recorded, showing "STEMI," but is unavailable. There was never ventricular fibrillation (VF) or ventricular tachycardia (VT), no shockable rhythm. Put it all together, and this is a sudden severe spontaneous intracranial hemorrhage, probably a ruptured cerebral aneuyrms (subarachnoid hemorrhage).
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