Remove Ischemia Remove Research Remove STEMI
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Will this case be flagged for Quality Improvement in the STEMI/NSTEMI Paradigm?

Dr. Smith's ECG Blog

Theres ST elevation in V3-4 which meets STEMI criteria, which could be present in either early repolarization, pericarditis or injury. Lets see what happens in the current STEMI paradigm. Emergency physician: STEMI neg but with elevated troponin = Non-STEMI The first ECG was signed off. What do you think?

STEMI 52
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How cardiogenic shock in NSTEMI is different from STEMI?

Dr. S. Venkatesan MD

Cardiogenic shock (CS)is the most feared event following STEMI. We tend to perceive CS as an exclusive complication of STEMI. The incidence is half of that of STEMI, i.e., 2.5-5%. might show little elevation with considerable overlap of left main STEMI vs NSTEMI ) 2.Onset ACS pathophysiology is not that simple.

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What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Dr. Smith's ECG Blog

This suggests further severe ischemia. Contemporary research studies of MINOCA have evaluated the prognosis of these patients, reporting a 12-month all-cause mortality of 4.7% (95% confidence interval, 2.6–6.9), This has resulted in an under-representation of STEMI MINOCA patients in the literature. Downstream vasospasm?

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Cardiac arrest: even after the angiogram, the diagnosis is not always clear

Dr. Smith's ECG Blog

STE limited to aVR is due to diffuse subendocardial ischemia, but what of STE in both aVR and V1? The last section is a detailed discussion of the research on aVR in both STEMI and NonSTEMI. Cardiac arrest can cause diffuse subendocardial ischemia, usually transient (it often resolves as time goes by after ROSC).

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Why do we NOT name Occlusion MI (OMI) after an EKG finding? (In contrast to STEMI, which is named after ST Elevation)

Dr. Smith's ECG Blog

Here is his ECG: There is no clear evidence of OMI or ischemia. Moreover, the research which appears to confirm this idea was indeed in relation to the circumflex, but they did not study Occlusion ; rather, they studied asymptomatic coronary disease. A 40-something male with no previous cardiac disease presented with chest pain.

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46 year old with chest pain develops a wide complex rhythm -- see many examples

Dr. Smith's ECG Blog

The receiving emergency physician consulted with interventional cardiology who stated there was no STEMI. Is there STEMI? Possible mechanisms of ventricular arrhythmias elicited by ischemia followed by reperfusion. Circulation Research , 56 (2), 184–194. The patient continued having chest pain. What is the rhythm?

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Heart Pump Improves Survival After Severe Heart Attacks

DAIC

The new trial, called DanGer Shock , is the first trial powered to examine whether the use of micro-axial flow pumps can improve survival in ST-elevation myocardial infarctions (STEMI, the most serious type of heart attack) that are complicated by cardiogenic shock. Overall, we have more complications, but we also save lives.”