Search Results for: anterior MI

Left ventricular aneurysm vs. acute anterior STEMI

Entry Img

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

Entry Img

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

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

Entry Img

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

Entry Img

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

Entry Img

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

Entry Img

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

Entry Img

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

Are all STEMI patients the same?

Entry Img

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

Entry Img

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 […]

Left anterior fascicular block (LAFB)

Entry Img

A reader by the name of Jesse contacted me and wrote: I have a question. I’m trying to learn more about fasicular and hemi blocks. I was curious if you have posted, or intend to post, any information regarding these. I understand this is all done on your free time, so no rush at all. […]

Page 1 of 812345...Last »

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Dan August
“Bad heartburn” – 82 y.o. female without chest pain.
Correction S* and T wave.
2014-08-21 01:53:14
Dan August
“Bad heartburn” – 82 y.o. female without chest pain.
ST elevation in all leads is caused by early repolarization. That's why the Q and T are mashed together. Could be a stemi, but you can't tell with this going on.
2014-08-21 01:51:45
Brooks Walsh MD
“Bad heartburn” – 82 y.o. female without chest pain.
Very interesting discussion - I had not anticipated the degree to which giving/not giving nitro would be controversial! I had my own agenda in presenting this case, but I think it would be better to follow the interest of our readers. I'll add a few pearls about ACS, nitro, and inferior STEMIs in my discussion…
2014-08-21 00:14:19
Sassy
“Bad heartburn” – 82 y.o. female without chest pain.
Our local protocols prevent administration of GTN to RVI, Inferior STEMI with BP less than 160 systolic or HR less than 50bpm. As more than 50% of inferior MI's have RV involvement you walk a very fine line between preload and none. The HR could possibly indicate RCA occlusion so there's one side of your…
2014-08-20 22:23:14
Jonathan
“Bad heartburn” – 82 y.o. female without chest pain.
*Strongly consider withholding GTN and Morphine which could decrease venous return.
2014-08-20 21:22:02

STEMI Expert?

  • Click here to find out!
  • 12-Lead ECG Challenge Smartphone App

    Photobucket

    12-Lead ECG Challenge Smartphone App - $5.99

  • Apple iOS
  • Android
  • Amazon
  • Web Based

  • FRN-TV video review
  • iMedicalApps.com review
  • Interested in resuscitation?

    FireEMS Blogs eNewsletter

    Sign-up to receive our free monthly eNewsletter

    Visitor Map / Stats

    Locations of visitors to this page


    LATEST EMS NEWS

    HOT FORUM DISCUSSIONS