Dr. Smith's ECG Blog

SEPTEMBER 12, 2024

The paramedic called the EM physician ahead of arrival and discussed the case and ECGs, and both agreed upon activating "Code STEMI" (even though of course it is not STEMI by definition), so that the acute LAD occlusion could be treated as fast as possible. So the cath lab was activated. Long term outcome is unavailable.

Chest Pain 121

Chest Pain STEMI Cardiogenic Shock Heart Failure 121

American College of Cardiology

MAY 23, 2024

What is the prognostic significance of various microvascular injury (MVI) patterns after ST-segment elevation myocardial infarction (STEMI)?

STEMI 73

STEMI Myocardial Infarction Article 73

Dr. Smith's ECG Blog

JANUARY 3, 2024

Interpretation : diagnostic of acute anterior OMI with STE less than STEMI criteria in V1-V4, hyperacute T waves in V2-V4, and suspiciously flat isoelectric ST segments in III and aVF suspicious for reciprocal findings. Now it even meets STEMI criteria, and HATWs continue to inflate. So the cath lab was not activated. Ongoing OMI.

STEMI 103

STEMI Chest Pain Ischemia Outcomes 103

Med Page Today

APRIL 9, 2024

(MedPage Today) -- ATLANTA -- Routine use of the Impella CP microaxial flow pump significantly improved survival in patients with infarct-related cardiogenic shock, the randomized DanGer Shock trial showed. In more than 350 patients receiving.

Cardiogenic Shock 115

Cardiogenic Shock STEMI 115

American College of Cardiology

NOVEMBER 7, 2024

What is the impact of complete revascularization versus culprit-only revascularization on outcomes in older patients with ST-segment elevation myocardial infarction (STEMI) and non–ST-segment elevation myocardial infarction (NSTEMI)?

STEMI 68

STEMI Myocardial Infarction Outcomes Article 68

Dr. Smith's ECG Blog

MAY 31, 2023

Cath lab declined as it is not a STEMI." And now this finding is even formally endorsed as a "STEMI equivalent" in the 2022 ACC guidelines!!! Another myocardial wall is sacrificed at the altar of the STEMI/NonSTEMI mindset. Do NOT give it unless you are committed to the cath lab!! Cath attending is aware. It is a mass delusion.

STEMI 96

STEMI Chest Pain Myocardial Infarction Ischemia 96

Dr. Smith's ECG Blog

JULY 7, 2024

So while there’s no diagnostic STEMI criteria, there are multiple ischemic abnormalities in 11/12 leads involving QRS, ST and T waves, which are diagnostic of a proximal LAD occlusion. First trop was 7,000ng/L (normal 25% of ‘Non-STEMI’ patients with delayed angiography have the exact same pathology of acute coronary occlusion.

Chest Pain 67

Chest Pain STEMI Blog Arrhythmia 67

ECG Cases

JUNE 18, 2024

To support EM Cases, please consider a donation here: [link] The post EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments appeared first on Emergency Medicine Cases.

STEMI 73

STEMI 73

ECG Guru

DECEMBER 23, 2023

The Patient: A 60-year-old man at work. He experienced a sudden onset of substernal chest pain, nausea & vomiting, and dizziness. He states the pain is a 5 on 1-10 scale. No cardiac history or current medications. The ECGs: The first ECG , taken at 12:30:05, shows a sinus rhythm with ventricular bigeminy.

STEMI 102

STEMI Chest Pain 102

American College of Cardiology

SEPTEMBER 18, 2024

What are long-term clinical benefits of complete versus culprit-only revascularization among ST-segment elevation myocardial infarction (STEMI) patients aged ≥75 years?

STEMI 58

STEMI Myocardial Infarction Article 58

American College of Cardiology

JUNE 21, 2024

What is the safety and effectiveness of P2Y12 inhibitor pretreatment in patients transferred for primary percutaneous coronary intervention (PPCI) within a regional ST-segment elevation myocardial infarction (STEMI) network?

STEMI 60

STEMI Myocardial Infarction Article 60

Frontiers in Cardiovascular Medicine

OCTOBER 9, 2024

We developed a user-friendly web application for real-world use, yielding risk scores as a percentage.ConclusionsThe STEMI-ML score effectively predicts in-hospital outcomes in STEMI patients and may assist with risk stratification and individualising patient management.

STEMI 52

STEMI Hospital ICU Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 27, 2023

The biggest problem with STEMI criteria are false negatives – because this costs patient’s myocardium, with greater mortality and morbidity. For this reason, ECGs need first to be interpreted in isolation, and then applied to the patient. Could this false positive cath lab activation been prevented?

Chest Pain 110

Chest Pain STEMI Ischemia Anatomy 110

American College of Cardiology

OCTOBER 9, 2024

What are the outcomes of bivalirudin vs. heparin anticoagulation during percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI)?

STEMI 53

STEMI Myocardial Infarction Outcomes Article 53

American College of Cardiology

APRIL 7, 2024

Implantation of the Impella CP micro-axial flow pump may increase survival at six months among patients with STEMI complicated by cardiogenic shock (CS), according to the results of the DanGer Shock study.

Cardiogenic Shock 60

Cardiogenic Shock STEMI Article 60

Dr. Smith's ECG Blog

JULY 9, 2024

Despite anticipation by many that the initial post-resuscitation ECG will show an obvious acute infarction — this expected "STEMI picture" is often not seen.

Defibrillator 117

Defibrillator STEMI Cardiac Arrest Cardiogenic Shock 117

Heart BMJ

OCTOBER 10, 2024

Introduction ST-segment elevation myocardial infarction (STEMI) diagnosis is based on a clinical presentation and ST-segment elevation (STE) in at least two consecutive leads. 1 This paradox stems from the incorporation bias and feedback sanction bias detailed in subsequent paragraphs.

STEMI 52

STEMI Myocardial Infarction 52

Dr. S. Venkatesan MD

MAY 16, 2024

True bifurcation STEMI with static thrombus (Carinal trapping of thrombus ,Coronary Lerish sydrome ) 4. Embolic STEMI with showers of emboli into both LCX and LAD Simultaneous or sequential Anterior and Inferior STEMI 5. Wrap around LAD true Global MI 2. RCA-dependent LAD circulation through collaterals 3.

STEMI 52

STEMI Pericarditis Embolism Circulation 52

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.

Cardiogenic Shock 52

Cardiogenic Shock STEMI Myocardial Infarction Document 52

Dr. Smith's ECG Blog

MAY 27, 2024

The ECG did not meet STEMI criteria, and the final cardiology interpretation was “ST and T wave abnormality, consider anterior ischemia”. There’s only minimal ST elevation in III, which does not meet STEMI criteria of 1mm in two contiguous leads. But STEMI criteria is only 43% sensitive for OMI.[1]

Chest Pain 123

Chest Pain STEMI Myocardial Infarction Ischemia 123

Dr. Smith's ECG Blog

JUNE 7, 2024

Obvious infero-postero-lateral STEMI(+)OMI, regardless of context Now let’s put them in order: what was the sequence? With serial ECGs that are ‘STEMI negative’ the physician could have waited for serial troponin levels or referred the patient as “non-STEMI”. What was the outcome and final diagnosis?

Chest Pain 113

Chest Pain STEMI Outcomes Document 113

All About Cardiovascular System and Disorders

FEBRUARY 6, 2024

STEMI – Anterior Wall ECG shows ST elevation myocardial infarction of anterior wall. Up sloping elevation of ST segment is seen in leads V1 to V5, with maximum ST elevation in V2, as is characteristic of anterior wall infarction.

STEMI 52

STEMI Myocardial Infarction Aneurysm Electrophysiology 52

ECG Cases

FEBRUARY 13, 2024

The post ECG Cases 48 – ECG Interpretation in Cardiac Arrest appeared first on Emergency Medicine Cases.

Cardiac Arrest 121

Cardiac Arrest STEMI Blog 121

Dr. Smith's ECG Blog

NOVEMBER 27, 2024

Doing so literally enables those of us who embrace the OMI Paradigm the ability to recognize within seconds that a patient with new CP ( C hest P ain ) — and — one or more hyperacute T waves — needs prompt cath regardless of potential absence of STEMI criteria.

Blog 133

Blog STEMI Research Outcomes 133

Frontiers in Cardiovascular Medicine

DECEMBER 3, 2024

However, whether immediate blood glucose and FIB levels affect coronary blood flow during primary percutaneous coronary intervention (PCI) remains unclear.ObjectiveTo explore the correlation between admission blood glucose (ABG), fibrinogen (FIB) and slow blood flow during primary PCI for acute ST segment elevation myocardial infarction (STEMI).MethodsA

Myocardial Infarction 52

Myocardial Infarction STEMI Risk Factors Hospital 52

Frontiers in Cardiovascular Medicine

JANUARY 7, 2024

Background Different ST-segment elevation myocardial infarction (STEMI) localizations go along with dissimilarities in the size of the affected myocardium, the causing coronary vessel occlusion, and the right ventricular participation. Results Of the 2,195 patients, 1,118 had an anterior (AWS)- and 1,077 a non-anterior-wall-STEMI (NAWS).

Myocardial Infarction 59

Myocardial Infarction STEMI 59

American College of Cardiology

DECEMBER 19, 2024

Implementing and tracking quality improvement (QI) metrics may lead to improved outcomes in patient care after STEMI in low- and middle-income countries (LMIC), according to an analysis of data from the ACC's Global Heart Attack Treatment Initiative (GHATI).

STEMI 49

STEMI Heart Attack Heart attacks Patient Care 49

American College of Cardiology

NOVEMBER 5, 2024

A small proportion of patients with STEMI treated via primary PCI experienced late ventricular tachycardia (VT) or ventricular fibrillation (VF), occurring one or more days following the procedure, but late VT or VF with cardiac arrest occurred rarely, especially among patients with uncomplicated STEMI, according to a study published in JAMA Network (..)

STEMI 49

STEMI Chest Pain Cardiac Arrest Tachycardia 49

Dr. Smith's ECG Blog

APRIL 18, 2024

I sent this to the Queen of Hearts So the ECG is both STEMI negative and has no subtle diagnostic signs of occlusion. Non-STEMI guidelines call for “urgent/immediate invasive strategy is indicated in patients with NSTE-ACS who have refractory angina or hemodynamic or electrical instability,” regardless of ECG findings.[1]

STEMI 121

STEMI Chest Pain Myocardial Infarction Blog 121

Cardiovascular Diabetology

JANUARY 3, 2025

Yet, the impact of GLP-1RA treatment before ST-segment elevation myocardial infarction (STEMI) on. Glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment reduces cardiovascular events in type 2 diabetes.

Myocardial Infarction 115

Myocardial Infarction Diabetes STEMI Research 115

Dr. Smith's ECG Blog

APRIL 6, 2024

In fact, it read: ** **ACUTE MI / STEMI ** ** The physicians caring for the patient activated the cath lab for "STEMI". But the conventional algorithm diagnosed STEMI, and an emergency physician activated the cath team based on this ECG. To an experienced interpreter, it is clearly not due to OMI.

Chest Pain 122

Chest Pain STEMI Hospital 122

The British Journal of Cardiology

NOVEMBER 29, 2023

Primary percutaneous coronary intervention (PPCI) remains the gold-standard treatment for ST-elevation myocardial infarction (STEMI). We present the case of a man in his 50s, admitted with cardiac arrest secondary to inferolateral STEMI.

STEMI 52

STEMI Cardiac Arrest Myocardial Infarction Ultrasound 52

Med Page Today

OCTOBER 29, 2024

(MedPage Today) -- The heparin frequently given before percutaneous coronary intervention (PCI) should be pushed to as early as possible in patients with ST-segment elevation myocardial infarction (STEMI), according to findings from the Chinese.

Heart Attack 111

Heart Attack Heart attacks Myocardial Infarction STEMI 111

Dr. Smith's ECG Blog

MARCH 31, 2024

The interventional cardiologist then canceled the activation and returned the patient to the ED without doing an angiogram ("Not a STEMI"). I advised that perhaps posterior leads would help to persuade the interventionalist, since the 2022 ACC recommendations include posterior STEMI as a formal STEMI equivalent, but only officially by 0.5

Chest Pain 111

Chest Pain STEMI Ischemia Myocardial Infarction 111

DAIC

OCTOBER 7, 2024

7, 2024 — The Society for Cardiovascular Angiography & Interventions (SCAI) recently announced the publication of the Expert Consensus Statement on the Management of Patients with STEMI Referred for Primary PCI. tim.hodson Mon, 10/07/2024 - 14:45 Oct.

STEMI 40

STEMI Catheterization Laboratory Best Practices Document 40

Dr. Smith's ECG Blog

JUNE 15, 2023

I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict: You can subscribe for news and early access (via participating in our studies) to the Queen of Hearts here: [link] queen-form Then I learned that a Code STEMI was activated for concern of anterior "STEMI" in V1-V2. High sensitivity troponin I was 23 ng/L.

STEMI 98

STEMI Chest Pain Stenosis Outcomes 98

American College of Cardiology

OCTOBER 28, 2024

The goal of the HELP-PCI trial was to determine the efficacy and safety of administering unfractionated heparin at first medical contact versus during cardiac catheterization only in patients with ST-segment elevation myocardial infarction (STEMI).

STEMI 49

STEMI Myocardial Infarction Article 49