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. Smith's ECG Blog
OCTOBER 26, 2011
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. He had been awakened by cough at 3 AM 2 days earlier.
Dr. Smith's ECG Blog
DECEMBER 23, 2014
The patient was diagnosed with esophageal reflux and was being discharged by the nurse when he had a cardiac arrest. Anterolateral STEMI. The formula results in 23.43, just above the 23.4 He was defibrillated. Here is his post resuscitation ECG: Now the diagnosis is obvious.
EMS 12-Lead
MARCH 19, 2023
David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (Ret) @DidlakeDW Expert contribution by Dr Robert Herman @RobertHermanMD @PowerfulMedical (Chief Medical Officer) An adult male called 911 for new-onset epigastric burning. Fire/EMS crews found him clammy and uncomfortable. Is this OMI?
Dr. Smith's ECG Blog
MARCH 30, 2014
One of my most talented readers is a health care assistant (a nursing assistant) who has taken a keen interest in ECGs. Trop T now very high, well into the range one sees with a STEMI; very unusual in type II MI. And they teach me a lot. He can beat nearly anyone. So you don't have to be highly trained. You don't have to be a genius.
Dr. Smith's ECG Blog
JULY 3, 2018
At 0800 the cardiology fellow is called to the bedside by the nurse as the patient again complains about 4/10 chest pain. Despite ongoing chest discomfort and an uptrending troponin, he never meets STEMI criteria. Despite having acute coronary occlusion by cath, his ECGs never met STEMI criteria. ng/mL (mildly elevated).
EMS 12-Lead
MAY 20, 2022
David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review and commentary by Dr. Steve Smith [link] @SmithECGblog It is early-summer, approximately 1330 hours, no cloud cover overhead, and 86 degrees with high humidity. As it currently stands, an ST/S ratio >15% should raise awareness for new anterior STEMI.
Expert insights. Personalized for you.
79 
Let's personalize your content