Dr. Smith's ECG Blog

OCTOBER 30, 2023

A 60 yo with 2 previous inferior (RCA) STEMIs, stented, called 911 for one hour of chest pain. Here is his most recent previous ECG: This was recorded after intervention for inferior STEMI (with massive ST Elevation, see below), and shows inferior Q-waves with T-wave inversion typical of completed inferior OMI. ng/mL (quite large).

STEMI 112

STEMI Heart Failure Stent Stents 112

Heart BMJ

OCTOBER 10, 2024

Introduction ST-segment elevation myocardial infarction (STEMI) diagnosis is based on a clinical presentation and ST-segment elevation (STE) in at least two consecutive leads. 1 This paradox stems from the incorporation bias and feedback sanction bias detailed in subsequent paragraphs.

STEMI 52

STEMI Myocardial Infarction 52

American College of Cardiology

OCTOBER 9, 2024

What are the outcomes of bivalirudin vs. heparin anticoagulation during percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI)?

STEMI 49

STEMI Myocardial Infarction Outcomes Article 49

American College of Cardiology

SEPTEMBER 18, 2024

What are long-term clinical benefits of complete versus culprit-only revascularization among ST-segment elevation myocardial infarction (STEMI) patients aged ≥75 years?

STEMI 54

STEMI Myocardial Infarction Article 54

American College of Cardiology

MAY 23, 2024

What is the prognostic significance of various microvascular injury (MVI) patterns after ST-segment elevation myocardial infarction (STEMI)?

STEMI 73

STEMI Myocardial Infarction Article 73

ECG Cases

APRIL 11, 2023

How can we use the awareness of complications to identify false positive STEMI and Occlusion MI that doesn’t meet classic STEMI criteria, and consider specific treatment? The post ECG Cases 41 – STEMI, Occlusion MI Complications appeared first on Emergency Medicine Cases.

STEMI 82

STEMI 82

Dr. Smith's ECG Blog

JULY 7, 2024

So while there’s no diagnostic STEMI criteria, there are multiple ischemic abnormalities in 11/12 leads involving QRS, ST and T waves, which are diagnostic of a proximal LAD occlusion. First trop was 7,000ng/L (normal 25% of ‘Non-STEMI’ patients with delayed angiography have the exact same pathology of acute coronary occlusion.

Chest Pain 66

Chest Pain STEMI Blog Arrhythmia 66

Dr. Smith's ECG Blog

SEPTEMBER 12, 2024

The paramedic called the EM physician ahead of arrival and discussed the case and ECGs, and both agreed upon activating "Code STEMI" (even though of course it is not STEMI by definition), so that the acute LAD occlusion could be treated as fast as possible. So the cath lab was activated. Long term outcome is unavailable.

Chest Pain 116

Chest Pain STEMI Cardiogenic Shock Heart Failure 116

DAIC

OCTOBER 7, 2024

7, 2024 — The Society for Cardiovascular Angiography & Interventions (SCAI) recently announced the publication of the Expert Consensus Statement on the Management of Patients with STEMI Referred for Primary PCI. tim.hodson Mon, 10/07/2024 - 14:45 Oct.

STEMI 52

STEMI Catheterization Laboratory Best Practices Document 52

Circulation

NOVEMBER 11, 2024

Background:Little is known about the clinical relevance of interleukin (IL)-6 and the severity of patients with acute ST-elevation myocardial infarction (STEMI). This study examined the possible associations of plasma IL-6 concentrations with TIMI scores in STEMI patients treated with primary percutaneous coronary intervention (PCI).Methods:The

STEMI 40

STEMI Myocardial Infarction Tricuspid Biomarkers 40

Dr. Smith's ECG Blog

DECEMBER 5, 2023

Beyond STEMI: Diagnosing Acute Coronary Occlusion on the ECG. The Queen of Hearts AI app can do it for you. With explainability too.

STEMI 127

STEMI Webinar 127

American College of Cardiology

JUNE 21, 2024

What is the safety and effectiveness of P2Y12 inhibitor pretreatment in patients transferred for primary percutaneous coronary intervention (PPCI) within a regional ST-segment elevation myocardial infarction (STEMI) network?

STEMI 56

STEMI Myocardial Infarction Article 56

Dr. S. Venkatesan MD

DECEMBER 29, 2023

Cardiogenic shock (CS)is the most feared event following STEMI. We tend to perceive CS as an exclusive complication of STEMI. The incidence is half of that of STEMI, i.e., 2.5-5%. might show little elevation with considerable overlap of left main STEMI vs NSTEMI ) 2.Onset ACS pathophysiology is not that simple.

Cardiogenic Shock 52

Cardiogenic Shock STEMI Myocardial Infarction Outcomes 52

American College of Cardiology

NOVEMBER 5, 2024

A small proportion of patients with STEMI treated via primary PCI experienced late ventricular tachycardia (VT) or ventricular fibrillation (VF), occurring one or more days following the procedure, but late VT or VF with cardiac arrest occurred rarely, especially among patients with uncomplicated STEMI, according to a study published in JAMA Network (..)

STEMI 46

STEMI Chest Pain Cardiac Arrest Tachycardia 46

Dr. S. Venkatesan MD

MAY 16, 2024

True bifurcation STEMI with static thrombus (Carinal trapping of thrombus ,Coronary Lerish sydrome ) 4. Embolic STEMI with showers of emboli into both LCX and LAD Simultaneous or sequential Anterior and Inferior STEMI 5. Wrap around LAD true Global MI 2. RCA-dependent LAD circulation through collaterals 3.

STEMI 52

STEMI Pericarditis Embolism Circulation 52

All About Cardiovascular System and Disorders

FEBRUARY 6, 2024

STEMI – Anterior Wall ECG shows ST elevation myocardial infarction of anterior wall. Up sloping elevation of ST segment is seen in leads V1 to V5, with maximum ST elevation in V2, as is characteristic of anterior wall infarction.

STEMI 52

STEMI Myocardial Infarction Aneurysm Electrophysiology 52

ECG Cases

JUNE 18, 2024

To support EM Cases, please consider a donation here: [link] The post EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments appeared first on Emergency Medicine Cases.

STEMI 68

STEMI 68

Dr. S. Venkatesan MD

OCTOBER 31, 2024

Time window s for intervention for thrombolysis in STEMI starts from onset of chest pain, but when it comes to primary PCI, a different time window takes the center stage pushing the former to the background. How can we have uniform std of 90-120 minutes D2B in all STEMI cases ? Why is this disparity?

STEMI 52

STEMI Chest Pain Anatomy Thrombolysis 52

Dr. Smith's ECG Blog

JANUARY 3, 2024

Interpretation : diagnostic of acute anterior OMI with STE less than STEMI criteria in V1-V4, hyperacute T waves in V2-V4, and suspiciously flat isoelectric ST segments in III and aVF suspicious for reciprocal findings. Now it even meets STEMI criteria, and HATWs continue to inflate. So the cath lab was not activated. Ongoing OMI.

STEMI 85

STEMI Chest Pain Ischemia Outcomes 85

Dr. Smith's ECG Blog

OCTOBER 31, 2024

But it does not meet the ridiculous "STEMI criteria" since there is not 1 mm of STE in any lead. So this is acute OMI. What does the Queen of Hearts say? (Dr. Lufkin did not need her) OMI with High Confidence Click here to sign up for Queen of Hearts Access.

STEMI 103

STEMI Arrhythmia Hospital Stent 103

Dr. Smith's ECG Blog

OCTOBER 27, 2024

The cath lab was deactivated by cardiologist on arrival at ED because it was "not a STEMI". Pt received 324 ASA and 2 sprays of nitro with improvement. Cath lab was activated by EMS and transported emergent." Further events: The patient continued to have pain and an NTG drip was started. Pain was decreased to 2/10.

STEMI 116

STEMI Chest Pain Myocardial Infarction Aneurysm 116

American College of Cardiology

APRIL 7, 2024

Implantation of the Impella CP micro-axial flow pump may increase survival at six months among patients with STEMI complicated by cardiogenic shock (CS), according to the results of the DanGer Shock study.

Cardiogenic Shock 56

Cardiogenic Shock STEMI Article 56

American College of Cardiology

AUGUST 31, 2024

The use of physiology-guided complete revascularization is superior to a culprit-only strategy for older patients with either STEMI or NSTEMI, according to a prespecified substudy of the FIRE trial presented at ESC Congress 2024 in London and simultaneously published in JACC.

STEMI 40

STEMI Physiology Article 40

Circulation

NOVEMBER 11, 2024

Introduction:Elevated LDL cholesterol is linked to microvascular injury and adverse cardiac events in STEMI patients. This study examines the impact of prior statin use on LDL levels at the time of MI, focusing on NSTEMI and STEMI patients. For STEMI, the treated group had an average LDL level of 87.8 ± 42 mg/dL versus 103 ± 41.2

STEMI 40

STEMI Cholesterol Myocardial Infarction Document 40

American College of Cardiology

OCTOBER 28, 2024

The goal of the HELP-PCI trial was to determine the efficacy and safety of administering unfractionated heparin at first medical contact versus during cardiac catheterization only in patients with ST-segment elevation myocardial infarction (STEMI).

STEMI 46

STEMI Myocardial Infarction Article 46

ECG Cases

JANUARY 17, 2023

In this ECG Cases blog we look at 9 patients with possible transient STEMI and discuss pitfalls and pearls in ECG interpretation and management. The post ECG Cases 39 – Transient STEMI Pitfalls and Pearls appeared first on Emergency Medicine Cases.

STEMI 52

STEMI Blog 52

Open Heart

JANUARY 27, 2023

Background ST elevation myocardial infarction (STEMI) represents a cardiac emergency. Inferior STEMI represents a dilemma for cardiologists. Methods We performed a single-centre retrospective cohort analysis of all patients admitted to our hospital from 2008 to 2020 with a diagnosis of inferior STEMI. to 0.78), respectively.

STEMI 52

STEMI Myocardial Infarction Hospital 52

American College of Cardiology

SEPTEMBER 18, 2024

STEMI remains a major cause of morbidity, mortality, disability, and high health care costs in Latin America and the rest of the world. New data assessing the impact of ACC's Global Heart Attack Initiative (GHATI) on patient care outcomes at the CEDIMAT Cardiovascular Center in Santo Domingo, Dominican Republic.

STEMI 43

STEMI Heart attacks Heart Attack Research 43

American College of Cardiology

JUNE 5, 2024

What is the impact of the administration of cangrelor at reperfusion on myocardial infarct (MI) size and microvascular obstruction (MVO) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI)?

STEMI 43

STEMI Myocardial Infarction Article 43

Circulation

NOVEMBER 11, 2024

Background:The computational pressure-fluid dynamics applied to index of microcirculatory resistance, derived from coronary angiography (CPFD-caIMR) is a promising alternative method of IMR to evaluate the prognosis of STEMI patients. All patients with STEMI underwent CPFD-caIMR and MVO assessment.

STEMI 40

STEMI Heart Failure Circulation Hospital 40

The British Journal of Cardiology

NOVEMBER 29, 2023

Primary percutaneous coronary intervention (PPCI) remains the gold-standard treatment for ST-elevation myocardial infarction (STEMI). We present the case of a man in his 50s, admitted with cardiac arrest secondary to inferolateral STEMI.

STEMI 52

STEMI Cardiac Arrest Myocardial Infarction Ultrasound 52

American College of Cardiology

MAY 20, 2024

Microvascular resistance reserve (MRR), as a measure of coronary microvascular dysfunction (CMD), can be a strong predictor of major adverse cardiovascular and cerebrovascular events (MACCE) at 12 months in patients with STEMI.

STEMI 40

STEMI Article 40

Frontiers in Cardiovascular Medicine

JANUARY 7, 2024

Background Different ST-segment elevation myocardial infarction (STEMI) localizations go along with dissimilarities in the size of the affected myocardium, the causing coronary vessel occlusion, and the right ventricular participation. Results Of the 2,195 patients, 1,118 had an anterior (AWS)- and 1,077 a non-anterior-wall-STEMI (NAWS).

Myocardial Infarction 59

Myocardial Infarction STEMI 59

Dr. Smith's ECG Blog

FEBRUARY 13, 2023

There’s inferior ST depression which is reciprocal to subtle lateral convex ST elevation, and the precordial T waves are subtly hyperacute – all concerning for STEMI(-)OMI of proximal LAD. There’s ST elevation I/aVL/V2 that meet STEMI criteria. This is obvious STEMI(+)OMI of proximal LAD. Non-STEMI or STEMI(-)OMI?

Chest Pain 52

Chest Pain STEMI Myocardial Infarction Electrocardiogram 52

ECG Guru

DECEMBER 23, 2023

The Patient: A 60-year-old man at work. He experienced a sudden onset of substernal chest pain, nausea & vomiting, and dizziness. He states the pain is a 5 on 1-10 scale. No cardiac history or current medications. The ECGs: The first ECG , taken at 12:30:05, shows a sinus rhythm with ventricular bigeminy.

STEMI 105

STEMI Chest Pain 105

American College of Cardiology

MAY 20, 2024

Microvascular resistance reserve (MRR) measured directly after primary PCI was an independent predictor of all-cause mortality or hospitalization for heart failure (HF) in patients with a STEMI over long-term follow-up, according to the results of a pooled analysis.

STEMI 40

STEMI Hospital Heart Failure Article 40

Dr. S. Venkatesan MD

MAY 16, 2024

If the thrombus migrates to one of the branches, it might evolve either as LAD STEMI, LCX STEMI, or a combination of both. We have seen a few lucky Left main STEMIs in the cath lab, with some spontaneous canalization. Most such patients do not reach the hospital. Final message De-novo Coronary Leriche syndrome is a real entity.

STEMI 40

STEMI Aortic Hospital 40