Pulmonary STEMI Stent 
Dr. Smith's ECG Blog
APRIL 12, 2013
A male in his 40's who had been discharged 6 hours prior after stenting of an inferoposterior STEMI had sudden severe SOB at home 2 hours prior to calling 911. He was in acute distress from pulmonary edema, with a BP of 180/110, pulse 110. Is this acute STEMI? Is this an acute STEMI? -- Unlikely!
Dr. Smith's ECG Blog
JANUARY 27, 2024
Old ‘NSTEMI’ A history of coronary artery disease and a stent to the same territory further increases pre-test likelihood of acute coronary occlusion, including in-stent thrombosis. The patient had a history of ‘NSTEMI’ a decade prior, with an RCA stent. So this NSTEMI was likely a STEMI(-)OMI with delayed reperfusion.
Dr. Smith's ECG Blog
MAY 20, 2024
In SCAPE (sympathetic crashing acute pulmonary edema), Emergency providers seem now to regularly give high dose NTG, but when the BP is 170/105 in a patient who is not crashing, we often fail to give something to lower afterload. __ Here are some Images: The red circle shows the LAD coursing down the anterior interventricular sulcus.
Dr. Smith's ECG Blog
FEBRUARY 18, 2012
There was some pulmonary edema. This is typical for subendocardial ischemia, not STEMI, and often means left main ischemia or 3 vessel ischemia. Right sided ECGs are best recorded in the context of inferior STEMI. Because of precordial ST depression, clinicians were also worried about posterior STEMI. This is her ECG 1.5
Dr. Smith's ECG Blog
OCTOBER 6, 2024
The door to balloon time was incredibly short and there was a 100% circumflex occlusion that was opened and stented. The Non-STEMI, which was an OMI, was diagnosed much faster with AI on the ECG than with troponin. I wonder if this patient had pulmonary disease? Then the high sensitivity troponin T returned at 1400 ng/L.
Dr. Smith's ECG Blog
DECEMBER 14, 2016
The "criteria" for posterior STEMI are 0.5 Is it STEMI or NonSTEMI? The patient had been on a long drive, suggesting possible pulmonary embolism (this was unlikely given absence of tachyardia, hypoxia, or any other feature of PE), so we sent a d dimer. Patients with ACS and acute pulmonary edema 3. mm STE in one lead.
Dr. Smith's ECG Blog
NOVEMBER 22, 2023
Xray was consistent with pulmonary vascular congestion. 20% of cases that everyone would call a STEMI have a competely open artery by the time of angiogram 60-90 minutes later. Previously placed stents in the LAD (multiple) and mid circumflex and patent Formal echocardiogram: Normal left ventricular size and wall thickness.
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