2023 CAD STEMI 
Dr. Smith's ECG Blog
JANUARY 20, 2024
Scattered other nonobstructive CAD. This patient does not show up in the STEMI registry, and the time to reperfusion will likely not be identified as the problem that it was. Angiogram around 9am: Culprit lesion mid LAD 100% stenosis TIMI 0 TIMI 3 after PCI Severe apical dyskinesis, severe anteroapical akinesis.
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. Similarly, if a patient with known CAD presents with refractory ischemic chest pain, the ECG barely matters: the pre-test likelihood of acute coronary occlusion is so high that they need an emergent angiogram.
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Dr. Smith's ECG Blog
OCTOBER 1, 2023
A man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. She knows the baseline is normal, and she knows the STEMI(-) OMI one is diagnostic of OMI, with the highest possible confidence. We've come a long way in 2 years!
Dr. Smith's ECG Blog
JUNE 1, 2012
This was a middle aged female with a h/o CAD who presented to the ED by EMS sudden onset of central chest pressure 45 min prior to ED arrival with associated diaphoresis and SOB.  There is LVH and there are ST-T abnormalities (large inferior T-waves and ST elevation, with reciprocal findings in aVL).
Dr. Smith's ECG Blog
JUNE 18, 2013
So I went to look at the chart and here is the history: This patient with no h/o CAD had a couple of episodes of chest pain during the day, then presented with one hour of substernal chest pain that had some reproducibility but also improved from 10/10 to 5/10 with nitroglycerine. He was admitted to the hospital for a "rule out."
Dr. Smith's ECG Blog
DECEMBER 29, 2015
Case history A middle-aged woman with a history of HTN, but no prior CAD, presented to the ED with chest pain. would require the ST/S ratio to be 25% for diagnosis of STEMI in LVH. The physician was concerned about STEMI, but also worried that she was overreacting, with the potential that LVH was producing a "STEMI-mimic."
Dr. Smith's ECG Blog
NOVEMBER 22, 2023
20% of cases that everyone would call a STEMI have a competely open artery by the time of angiogram 60-90 minutes later. Patient stated that he has had glucose over 400 even though he has not missed any doses of insulin. Here is the ECG at that point in time: The ischemia is mostly resolved. Normal left ventricular wall thickness.
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