Ambulance Coronary STEMI 
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
She was brought in by ambulance and received aspirin and nitroglycerin en route. Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. Detailed coronary artery evaluation not performed.
Dr. Smith's ECG Blog
OCTOBER 15, 2024
A prehospital “STEMI” activation was called on a 75 year old male ( Patient 1 ) with a history of hyperlipidemia and LAD and Cx OMI with stent placement. He arrived to the ED by ambulance at 1529, only a half hour after the start of his chest pain around 1500 while eating. He wrote most of it and I (Smith) edited.
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Dr. Smith's ECG Blog
JUNE 5, 2023
A 40-something male presented by ambulance with one hour of chest pain that was improving after sublingual nitroglycerine and 325 mg of aspirin, chewed. Here it is: Obvious Inferior Posterior STEMI (+) OMI. Or had not had a prehospital ECG on the ambulance. Aside on ECG Research: 20% of Definite diagnostic STEMI (Cox et al.)
Dr. Smith's ECG Blog
DECEMBER 19, 2023
The ambulance report says "BP continued to drop during transport and pt remained cold and clammy." As per Dr. Frick — an all-too-common misconception is that the absence of obstructive coronary disease on cardiac catheterization rules out acute coronary occlusion as the cause of the patient's acute event. This is not the case.
Dr. Smith's ECG Blog
AUGUST 9, 2018
Ambulated to ambulance for eval. Here it is: The computer reads STEMI What do you think? More from the medic: "LifePak 15 interpretation was STEMI. My response: "I think it is very worrisome for STEMI." It meets STEMI criteria even for a male under age 40, with STE 2.84 No history, meds, or risk factors.
Dr. Smith's ECG Blog
JUNE 20, 2020
The medics were worried about STEMI, as it meets STEMI criteria. He rehydrated and had no orthostatic symptoms prior to discharge, ambulated well. - Discussion Thus, no further ECGs were recorded and there was no angiogram or stress test or CT coronary angiogram. What do you think? There is LVH.
Dr. Smith's ECG Blog
APRIL 20, 2018
The nitro she took in the ambulance did not help. If she had no risk factors, it is doubtful that she would have developed such extensive coronary artery disease as we see on the angiogram. Patients like her are the reason we are advocating for a change in the ACS paradigm from STEMI to OMI.
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