Ischemia Research STEMI 
Dr. Smith's ECG Blog
MARCH 27, 2025
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?
Dr. S. Venkatesan MD
DECEMBER 29, 2023
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.
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
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?
Dr. Smith's ECG Blog
OCTOBER 28, 2013
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).
Dr. Smith's ECG Blog
JUNE 1, 2022
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.
Dr. Smith's ECG Blog
JULY 31, 2018
It is equivalent to a transient STEMI. Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. It they are static, then they are not due to ischemia. This is better evidence for ischemia than any other data point. Again, cath lab was not activated.
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
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. From Gue at al.
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