Myocardial Infarction Pacemaker STEMI 
Dr. Smith's ECG Blog
MARCH 19, 2024
The patient presented to an outside hospital An 80yo female per triage “patient presents with chest pain, also hurts to breathe” PMH: CAD, s/p stent placement, CHF, atrial fibrillation, pacemaker (placed 1 month earlier), LBBB. Smith: This is an enormous myocardial infarction. Most large STEMI have peak troponin I in the 20.0
Dr. Smith's ECG Blog
OCTOBER 8, 2024
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].
Dr. Smith's ECG Blog
MAY 19, 2022
The important point for our purposes is that they do no represent myocardial infarction. Anterior STEMI? This gradual change in P wave morphology as the heart rate varies could be consistent with a wandering atrial pacemaker. Dr. Smith note: I wouldn't necessarily consider this ENTIRELY "benign." What is it?
Dr. Smith's ECG Blog
APRIL 8, 2022
There is clearly sufficient STE for STEMI criteria in leads V2 and aVL, but lead I has less than 1.0 mm of STE - thus, technically this ECG does not meet STEMI criteria, although it is a quite obvious OMI. This ECG was immediatel y discussed with the on-call cardiologist who said the ECG was "concerning but not a STEMI."
EMS 12-Lead
JUNE 20, 2022
A prehospital STEMI activation was transmitted to the closest PCI center, and 324mg ASA was administered. The attending crews were concerned for an ACS-equivalent of LAD occlusion and initiated a prehospital STEMI activation to the closest PCI center. It’s important to stress the presence of a normal QRS (i.e., References 1] Smith, S.
Dr. Smith's ECG Blog
FEBRUARY 15, 2018
100% occluded RCA with TIMI 0 flow Post drug-eluting stent placement with TIMI 3 flow While in the cath lab, she transiently developed complete heart block and became hypotensive requiring transvenous pacemaker placement and transient pressors. The transvenous pacemaker was removed the following day and pressors were not required again.
Dr. Smith's ECG Blog
JULY 19, 2024
It was read by the treating physician and the overreading cardiologist as "Paced, no STEMI." Immediate and early percutaneous coronary intervention in very high risk and high risk non-ST segment elevation myocardial infarction patients. How does the Queen of Hearts do? Ann Emerg Med [Internet]. 2012;60:766–776. 2023;131569.
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