Remove ICU Remove Myocardial Infarction Remove STEMI
article thumbnail

Machine-learning based risk prediction of in-hospital outcomes following STEMI: the STEMI-ML score

Frontiers in Cardiovascular Medicine

Final models were chosen to optimise area under the curve (AUC) score while ensuring interpretability.ResultsOverall, 128 (6.9%) patients died in hospital, with 292 (15.7%) patients requiring ICU admission and 373 (20.0%) patients with LVEF < 40%. for ICU admission, and 0.74 for in-hospital mortality, 0.78 for LVEF < 40%.

STEMI 52
article thumbnail

How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Dr. Smith's ECG Blog

Subtle as a STEMI." (i.e., A temporary pacemaker was implanted, and she was admitted to the ICU with cardiogenic shock. In our study, there were 20/53 complete LAD OMI (TIMI-0 flow) which did not meet STEMI criteria. None of the 20 ever evolved to STEMI criteria. This one is easy for the Queen. Ann Emerg Med [Internet].

article thumbnail

Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused

Dr. Smith's ECG Blog

Echo on the day after admission showed EF of 30-35% and antero-apical wall akinesis with an LV thrombus [these frequently form in complete or near complete (no early reperfusion) anterior STEMI because of akinesis/stasis] 2 more days later, this was recorded: ST elevation is still present. Zwolle Myocardial Infarction Study Group.

STEMI 52
article thumbnail

Over-diagnosing MI is not* as negligent as missing it!

Dr. S. Venkatesan MD

and ICU-related anxiety stand apart in this scientific comical game of ruling out a cardiac emergency. What we can do, at our level is to incorporate a new term “ benign or micro myocardial Infarction” – akin to lacunar infarcts or TIA equivalents of the brain in the heart. Reference 1.McCarthy

article thumbnail

What will you do for this patient transferred to you who is now asymptomatic?

Dr. Smith's ECG Blog

This is technically a STEMI, with 1.5 However, I think many practitioners might not see this as a clear STEMI, and would instead call this "borderline." They collected several repeat ECGs at the outside hospital before transport: None of these three ECGs meet STEMI criteria. This ECG was recorded on arrival: What do you think?

STEMI 52
article thumbnail

A dialysis patient with nonspecific symptoms and pseudonormalization of ST segments

Dr. Smith's ECG Blog

Fortunately, he was extubated several days later in the ICU with intact baseline mental status and was discharged shortly thereafter to subacute rehab. Acute myocardial infarction in patients with dialysis Patients on dialysis have a well studied history of underdiagnosis and undertreatment for acute myocardial infarction.

article thumbnail

OMI Can be Diagnosed by "Pseudonormalization of ST Segments"

Dr. Smith's ECG Blog

Pseudonormalization of STE and/or STD , as in this patient with LVH, but also in LBBB and other etiologies of chronic ST shift, should raise concern for OMI (Occlusion Myocardial Infarction). I took part in her ICU care and she was extubated and stable to transfer to a stepdown unit after a few days.