Coronary Heart Attack STEMI 
The Skeptics' Guide to EM
NOVEMBER 25, 2023
Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI. She is the cofounder of FOAMcast and a […] The post SGEM#421: I Think I’d Have a Heart Attack – Maybe Not in a Rural Area? Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI.
Dr. Smith's ECG Blog
MAY 13, 2024
He noted that his father died from a heart attack in his early 50s prompting his presentation to the emergency department. This ECG is highly concerning for LAD occlusion despite it not showing a STEMI criteria. Here is the initial ECG at 13:17 with no prior ECG in the patient’s chart for comparison: What do you think?
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Dr. Smith's ECG Blog
AUGUST 9, 2024
He reported a history of “Wolf-Parkinson-White” and “heart attack” but said neither had been treated. The receiving emergency physician consulted with interventional cardiology who stated there was no STEMI. Serial ECGs enhance the diagnosis of acute coronary syndrome. Is there STEMI? What is the rhythm?
Dr. Smith's ECG Blog
JANUARY 9, 2023
50% of LAD STEMIs do not have reciprocal findings in inferior leads, and many LAD OMIs instead have STE and/or HATWs in inferior leads instead. The ECG easily meets STEMI criteria in all leads V2-V6, as well. Repeat CT angio chest (not CT coronary, unclear what protocol) showed possible LAD aneurysm and thrombus. Pericarditis?
Dr. Smith's ECG Blog
NOVEMBER 23, 2022
He stated it was similar to prior heart attacks. Both hyperacute T waves and posterior OMI are now formally endorsed as "STEMI equivalents" by the ACC. == MY Comment, by K EN G RAUER, MD ( 11/23 /2022 ): == Cases in which initial ECG findings are subtle before undergoing dramatic change, — are always impressive.
Dr. Smith's ECG Blog
MARCH 2, 2009
male presents because he "thought he might be having a heart attack." First, this patient had a known stent in the "marginal" artery and thought he was having a heart attack. By definition, this is a non-STEMI because there is not 1 mm of ST elevation in 2 consecutive leads. How can you make the diagnosis?
Dr. Smith's ECG Blog
OCTOBER 10, 2022
He reportedly told his family "I think I'm having a heart attack", then they immediately drove him to the ED, and he was able to ambulate into the triage area before he collapsed and became unresponsive. CPR was initiated immediately. (The He had multiple cardiac arrests with ROSC regained each time.
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