Hypertension STEMI Tachycardia 
Dr. Smith's ECG Blog
APRIL 12, 2013
A male in his 40's who had been discharged 6 hours prior after stenting of an inferoposterior STEMI had sudden severe SOB at home 2 hours prior to calling 911. Here is his ED ECG: There is sinus tachycardia. Is this acute STEMI? Is this an acute STEMI? -- Unlikely! He had no chest pain. The cath lab was activated.
Dr. Smith's ECG Blog
SEPTEMBER 23, 2024
Written by Willy Frick with edits by Ken Grauer A woman in her 70s with a history of hypertension presented with acute onset shortness of breath. The conventional machine algorithm interpreted this ECG as STEMI. It shows sinus tachycardia with right bundle branch block. When EMS found her, she was dyspneic and diaphoretic.
Dr. Smith's ECG Blog
JANUARY 27, 2024
So this NSTEMI was likely a STEMI(-)OMI with delayed reperfusion. The patient was admitted as ‘NSTEMI’ which is supposed to represent a non-occlusive MI, but the underlying pathophysiology is analogous to a transient STEMI. See these posts: Chest Pain, ST Elevation, and an Elevated Troponin: Should we Activate the Cath Lab?
Dr. Smith's ECG Blog
SEPTEMBER 5, 2024
Sinus tachycardia has many potential causes. This is especially true for the elderly patient with sinus tachycardia. What is the cause of the sudden tachycardia? It has been estimated that in the aggregate, they occur at a rate of about 3 per 1000 patients with acute MI, and most of these events occur in patients with STEMI.
Dr. Smith's ECG Blog
MARCH 9, 2024
Written by Willy Frick A 67 year old man with a history of hypertension presented with three days of chest pain radiating to his back. The cardiologist agreed that the ECG was suggestive of STEMI, but the facility's cath lab was apparently not available and he therefore recommended emergent transfer to a cath capable facility.
Dr. Smith's ECG Blog
OCTOBER 17, 2024
The prehospital and ED computer interpretation was inferior STEMI: There’s normal sinus rhythm, first degree AV block and RBBB, normal axis and normal voltages. The paramedic notes called STEMI into question: “EMS disagree with monitor for STEMI callout. Past medical history included diabetes and hypertension.
Dr. Smith's ECG Blog
JANUARY 1, 2024
His medical history includes hypertension, a decade-long battle with diabetes, ischemic heart disease, a coronary bypass graft surgery ten years ago, a diagnosis of congestive heart failure for the last five years, and a prior ICD implantation five years ago. What is the rhythm? Smith : Are they P-waves? That was also my initial concern.
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