tag:blogger.com,1999:blog-549949223388475481.post8413099205680302120..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: What do you think the echocardiogram shows in this case?Unknownnoreply@blogger.comBlogger7125tag:blogger.com,1999:blog-549949223388475481.post-26039811388986983942020-05-18T08:37:29.269-05:002020-05-18T08:37:29.269-05:00Our pleasure!Our pleasure!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-3549987969464976552020-05-18T06:10:54.777-05:002020-05-18T06:10:54.777-05:00Thank you Dr Steve and Dr Ken!Thank you Dr Steve and Dr Ken!Anonymoushttps://www.blogger.com/profile/12943735023044008930noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-670027324859117262020-05-16T07:48:20.372-05:002020-05-16T07:48:20.372-05:00Giacomo, we are nearly done with a manuscript that...Giacomo, we are nearly done with a manuscript that will list the 7 findings of OMI that is not STEMI.<br /><br />Here they are:<br /><br /><br />Hyperacute T-waves<br />Pathologic Q-waves<br />Terminal QRS distortion (terminal QRS does not extend down to the baseline, with absence of both a J-wave and an S-wave)<br />Reciprocal STD and/or T-wave inversion<br />Subtle STE not meeting criteria<br />STD maximal in V2-V4<br />Any STE in inferior leads with any STD/T-wave inversion in aVL<br />Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-18481223868113115272020-05-15T13:39:17.664-05:002020-05-15T13:39:17.664-05:00Grazie Giacomo per le belle parole! Siamo felici c...Grazie Giacomo per le belle parole! Siamo felici che questo ECG Blog sia utile per te! (Thanks for the nice words! We’re happy this ECG Blog is useful for you!). Among the ECG findings that in the “right” clinical setting (ie, new-onset chest pain) may suggest acute OMI are: i) Hyperacute T waves; ii) Reciprocal ST-T wave changes (especially when a “mirror-image” picture of ST-T waves is seen between leads III and aVL); iii) ST elevation of ANY amount (even less than 1 mm) of a shape that suggests acute injury (especially when present in more than a single lead of a given lead area); iv) ST depression of the “right shape” post posterior involvement (ie, positive “mirror test”) in one or more anterior leads (especially if seen in association with suspicious-for-acute inferior lead changes); v) Terminal QRS distortion (terminal QRS does not extend down to the baseline, with absence of both a J-wave and an S wave in leads V2 or V3); vi) New development of infarction-Q-waves; vii) An overall “Gestalt picture” that might be difficult to “put into words”, in which a patient with worrisome new symptoms shows abnormal ST-T wave changes in multiple leads — that taken TOGETHER suggest acute OMI in progress; and viii) The finding of “dynamic” ST-T wave changes (on either serial tracings OR compared to a prior baseline ECG) — that in the setting of new worrisome symptoms suggest an ongoing acute process. Added to this might be findings from other testing (ie, positive troponin; stat Echo during chest pain showing localized wall motion abnormality). NOTE — As is probably apparent from the above — it may be hard to “put into words” all criteria without seeing a specific tracing — but hopefully the above will be helpful! P.S. — I’ve referred your excellent Question to Drs. Smith & Meyers for their additional input! — :)ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-31812658439760393022020-05-15T13:18:10.351-05:002020-05-15T13:18:10.351-05:00Thank you Andrea! — :)Thank you Andrea! — :)ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-50888918998307547842020-05-15T12:37:37.259-05:002020-05-15T12:37:37.259-05:00Dr Smith Can you list the OMI signs in addition to...Dr Smith Can you list the OMI signs in addition to the following ones?<br />subtle STE, hyperacute T-waves, ST depression V1-V4, decreased QRS amplitude, terminal QRS distortion<br /><br />This blog is really inspirational to me and it changed my approach to EKG radically.<br />Thank you.<br /><br />Giacomo from ItalyGiacomonoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-34251225353483986222020-05-15T03:15:23.810-05:002020-05-15T03:15:23.810-05:00Aortic dissection is another differential for this...Aortic dissection is another differential for this EKG. Important to remember because it directly affect the management (anti platelets and hnf/lmwh could lead to a disaster)<br /><br />Excellent blog ! Thanks doctorsAndreanoreply@blogger.com