Search Results for: anterior MI

Left ventricular aneurysm vs. acute anterior STEMI

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Some of you expressed concerns about the possibility of the ECG abnormality we sometimes refer to as left ventricular aneurysm (persistent ST-elevation after previous MI).

76 year old female CC: Chest pain – The case for this being an acute anterior STEMI

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As many of you pointed out, the history and clinical presentation isn’t exactly screaming “Acute Coronary Syndrome!”

Anterior T wave inversions and PE.

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Last week, I described the case of a middle-aged male with a vague history of heart failure who had been having progressive shortness of breath for 4-5 days. On the day he called 911, he had been walking a short distance when he syncoped. EMS obtained an ECG: Compared with the prior ECG, the anterior […]

Conclusion: 53 YOF with AMS: STEMI or Secondary ST-T changes?

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This is the conclusion to the previous case: 53 YOF with AMS: STEMI or Secondary ST-T changes? This female presented to the ED with Altered Mental Status (AMS), via ambulance, as STEMI ALERT, after completing approximately 3 hours of her usual dialysis. This was the 12 lead ECG provided by EMS…   We have a […]

QRS AXIS DETERMINATION

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During ECG interpretation, cardiac Axis, or direction of electrical impulses, may be normal (physiologic) or abnormal (pathologic), suggesting abnormal cardiac conductivity. Although every deflection obtained on the ECG will have an axis, we will focus on the ventricular axis. When we think of our cardiac monitoring lead placement, we have to understand cardiac Vectors, which is the […]

RBBB Abnormalities Missed

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The original presentation of this case appeared as  "What's Wrong with Mr. Wilson?"… You can read the original post here. Much has been written lately about RBBB abnormalities that were missed.  Dr. Smith has recently posted two cases here, and here discussing this. First, let's review the 12 lead of a typical RBBB. When learning […]

AHA changes acceptable time to primary PCI from 90 to 120 minutes for acute STEMI

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Thanks to Ivan Rokos, M.D. for pointing out an important change in the 2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention. Photo credit: Code STEMI Web Series at First Responders Network For years now many have complained about the AHA's official recommendation that primary PCI for acute STEMI be accomplished within 90 minutes of first medical […]

Excessive discordance as a marker of acute STEMI in LBBB

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Positively deflected QRS complexes can be expected to show ST-depression and inverted T-waves.

Are all STEMI patients the same?

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When it comes to regionalized STEMI care, we treat all STEMI patients the same. But are they the same? The answer is, "No!" Most EMS protocols include a maximum ground transport time of 30-60 when bypassing non-PCI hospitals (AHA Mission: Lifeline calls them "STEMI Referral Hospitals"). The idea is that when the "first medical contact-to-balloon" […]

Right ventricular hypertrophy vs. isolated posterior STEMI

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A reader of the Prehospital 12-Lead ECG blog asks, “How can you tell the difference (based on ECG criteria alone) between right ventricular hypertrophy and acute isolated posterior STEMI?” Well, the good news is you don’t have to tell “based on ECG criteria alone” and I’m sure all of my regular readers know that I […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Alex
100 yof CC: Rib pain and intermittent spasms
>>Too perfectly lined up with the T-waves, while the isoelectric line is relatively stable, to be strictly movement artifact. Can these spasms be sync-d with (or caused by) mechanical movement of the heart walls?
2014-11-25 23:20:19
Erich
What it Looks Like: Cardiac Arrest
Fantastic post, must see stuff for junior paramedics, medical students, residents and nurses that could potentially see cardiac arrest on a regular basis.
2014-11-25 16:22:28
LITFL Review 156
83 Year Old Male: Shortness of Breath
[…] ischaemia? Check out this case from the EMS 12 Lead blog. For more effective learning, read the original case first. […]
2014-11-25 09:09:03
ECG Axis Interpretation
The 360 Degree Heart – Part I
[…] http://www.ems12lead.com/2014/09/11/the-360-degree-heart-part-i/ […]
2014-11-25 09:01:37
LITFL Review 152 - LITFL
The 360 Degree Heart – Part I
[…] you understand axis as well as you’d like? The EMS 12-Lead blog gives us the first in a new series on understanding axis on the ECG. […]
2014-11-25 08:55:15
Us and them
Us and them
We Need Some New Stories
We Need Some New Stories
Safety: Hillsborough at 25
Safety: Hillsborough at 25
Respect in Ferguson and everywhere else
Respect in Ferguson and everywhere else
Missing
Missing

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