Books ED STEMI 
EMS 12-Lead
APRIL 2, 2022
Figure 1-1 My colleague, a faithful student of ECG interpretation, handed me the tracing and said that it warranted STEMI activation because of apparent terminal QRS distortion (TQRSD) in V2. ASA 324mg was administered while a STEMI activation was simultaneously transmitted to the nearest PCI center. Attached is the first ECG.
Dr. Smith's ECG Blog
SEPTEMBER 7, 2024
ECG 1 at time zero EARLY REPOLARIZATION ABNORMAL ECG ED final official overread: "early repol vs hyperacute T, minimal changes from previous (previous shown below)" What do YOU think? Smith : there is some minimal ST elevation in V2-V6, but does not meet STEMI criteria. Is it normal STE? This is a "Transient OMI".
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Dr. Smith's ECG Blog
APRIL 26, 2017
Note 2 other similar cases at the bottom that come from my book, The ECG in Acute MI. This meets "STEMI criteria" However, there is very high voltage, with a very deep S-wave in V2 and tall R-wave in V4. The morphology is not right for STEMI. To the ED providers, the patient denied CP, SOB, or drug use. What do you think?
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 15, 2013
It was worse on the evening prior to presentation while lying in bed, then recurred and resolved while at rest just prior to arriving in the ED. Here is the first ED ECG, with no pain: Sinus rhythm. The above principles are all well illustrated with this figure from my book, The ECG in Acute MI (2002). Computerized QTc = 419.
Dr. Smith's ECG Blog
MARCH 11, 2016
Her prehospital ECG was identical to her first ED ECG, and the cath lab was activated: There is massive ST elevation (greater than 15 mm) in V2 and V3, with ST elevation in I and aVL and reciprocal ST depression in II, III, aVF. This comes from chapter 28 of my book The ECG in Acute MI ). Peterson ED, Hathaway WR, Zabel KM, et al.
ACEP Now
JULY 6, 2023
Of course, the bill for any episode of emergency department (ED) care can be substantial, exceeding the billed charges for equivalent care provided in some primary care offices. Now, many acute pyelonephritis patients receive an IV antibiotic, analgesia, and an antiemetic in the ED. This process required at least a full day.
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