Remove CAD Remove Emergency Department Remove STEMI
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An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon. Diagnosis of Type I vs. Type II Myocardial Infarction in Emergency Department patients with Ischemic Symptoms (abstract 102).

CAD 126
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Something Winter This Way Comes

EMS 12-Lead

Otherwise, no admission of CAD, HLD, or family history of sudden cardiac death. link] deWinter first reported his unique characteristics of LAD occlusion in 2008, and since the respective ECG changes do not fit the conventional STEMI paradigm (as he even stated – “instead of signature ST-segment elevation” ….)

MICU 130
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Is OMI an ECG Diagnosis?

Dr. Smith's ECG Blog

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. I sent this to the Queen of Hearts So the ECG is both STEMI negative and has no subtle diagnostic signs of occlusion.

STEMI 121
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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting." Just because you don't see hemodynamically significant CAD on angiogram does not mean it is not OMI. This has resulted in an under-representation of STEMI MINOCA patients in the literature.

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Infection and DKA, then sudden dyspnea while in the ED

Dr. Smith's ECG Blog

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.

ED 119
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Management of STEMI (ST-Elevation Acute Myocardial Infarction)

ECG & Echo Learning

STEMI , ST-segment elevation acute myocardial infarction ). 1 Initial diagnosis of STEMI ECG Management Recommendation Level of evidence A 12-lead ECG should be interpreted immediately (within 10 minutes) at first medical contact. I B Designated PCI centres should provide angiography and reperfusion 24/7 without delay.

STEMI 40
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A Tough ECG, But Learn From It!

Dr. Smith's ECG Blog

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. Ann Emerg Med 1998;31(1):3-11. Fesmire et al.

STEMI 52