Ischemia Outpatient STEMI 
Dr. Smith's ECG Blog
MAY 23, 2014
This case shows a CT image of subendocardial ischemia. However, there are also Q-waves inferiorly and the inferior T-waves are inverted, suggesting that this is an old MI with persistent ST elevation, or, alternatively, a subacute or partially reperfused, inferior STEMI. This is all but diagnostic of inferior-posterior STEMI.
Dr. Smith's ECG Blog
OCTOBER 10, 2022
In terms of ischemia, there is both a signal of subendocardial ischemia (STD max in V5-V6 with reciprocal STE in aVR) AND a signal of transmural infarction of the inferior wall with Q wave and STE in lead III with reciprocal STD in I and aVL. The rhythm is atrial fibrillation. The QRS complex is within normal limits. These include.
Dr. Smith's ECG Blog
NOVEMBER 12, 2020
9 However, because troponin is a clear marker of disease severity and a powerful independent predictor of adverse outcomes, it may be quite useful in the ED disposition decision: if troponin is elevated, then outpatient management should be reconsidered. 12 All STEMI patients had very high cTn typical of STEMI (cTnT > 1.0
Dr. Smith's ECG Blog
MARCH 24, 2023
There’s minimal concave ST elevation in III which does not meet STEMI criteria, so this ECG is "STEMI negative". Use STEMI criteria to identify acute coronary occlusion: the ECG was STEMI negative 2. A repeat ECG was done on way to cath lab: "STEMI negative" again. The cath lab was activated. Take home 1.
Dr. Smith's ECG Blog
JANUARY 9, 2025
Smith : I recognize this as a STEMI mimic. Doesn't this necessarily mean that he was having ischemia? But vasovagal syncope typically has a prodrome such that further evaluation of today's patient may be needed as an outpatient to better assess for the cause of his sudden syncope. I was not alarmed.
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