2022 E-9-1-1 STEMI 
Dr. Smith's ECG Blog
SEPTEMBER 23, 2024
The conventional machine algorithm interpreted this ECG as STEMI. See this post of RV MI with both McConnell sign and "D" sign: Inferior and Posterior STEMI. Here is lead I from ECGs 1 and 2 shown side-by-side to highlight the change in axis from borderline right to completely normal. Her ECG is shown below: What do you think?
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
Post cath ECG: Now there are hyperacute T-waves again, and recurrent ST depression in V2 This ECG would normally diagnostic of OMI until proven otherwise No further troponins were measured, but it looks like there is recurrent OMI Next day: A CT Coronary Angiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. IMPRESSION: 1.
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Dr. Smith's ECG Blog
MAY 30, 2023
There is an obvious inferior posterior STEMI(+) OMI. We recorded an ECG in which V1-V3 were put in the position of V4R-V6R, and V4-6 were placed in V7-9 to (academically) confirm posterior OMI. 1 mg of Atropine was given and the heart rate increased transiently to 60. What is the atrial activity? How would one tell? What to do?
Dr. Smith's ECG Blog
JULY 14, 2023
Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. Figure-1: The initial ECG in today's case — obtained after ROSC.
Dr. Smith's ECG Blog
APRIL 22, 2022
But these cases show the potential dangers of delayed recognition and treatment of inferior reperfusion Take away 1. Rather than using terms like “STEMI” and “Wellens”, it’s more helpful to describe the underlying pathology and ECG pattern pattern: Occlusion MI, and reperfusion T wave inversion 4. JAMA Intern Med 2019 9.
Dr. Smith's ECG Blog
OCTOBER 15, 2022
As always, LAD OMI need not meet STEMI criteria and usually does NOT! Here are many examples which we have already posted: 5 of LVH mimicking Precordial Swirl 1 case (Case 6) of LVH mimicking precordial swirl, but it is actually LVH + posterior OMI 14 Cases (Cases 7-20) of OMI with Precordial Swirl First, 5 mimics: Case 1.
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
mm of ST segment elevation, V2 and V3 have 1 mm of elevation, v4 has 2 mm of elevation and v5 around 1.5 Note 1: Levels were significantly lower in takotsubo that presented with T-wave inversion. Reference on Troponins: Xenogiannis I, Vemmou E, Nikolakopoulos I, et al. Learning Points: 1. What do you think? V1 has 0.5
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