tag:blogger.com,1999:blog-549949223388475481.post314780087766982770..comments2024-03-26T22:42:04.176-05:00Comments on Dr. Smith's ECG Blog: What is the infarct artery? (Complex analysis, in this case)Unknownnoreply@blogger.comBlogger9125tag:blogger.com,1999:blog-549949223388475481.post-2528970552422775552016-07-13T05:32:13.542-05:002016-07-13T05:32:13.542-05:00Thanks, Jay!Thanks, Jay!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-38893429800298216702016-07-08T08:26:59.301-05:002016-07-08T08:26:59.301-05:00Thanks!
Predicting the Culprit Lesion in Acute I...Thanks! <br />Predicting the Culprit Lesion in Acute Inferior ST-Elevation Myocardial Infarction Based on Wellens’ Criteria and Tierala’s Algorithm<br />http://thritajournal.com/15607.fulltextSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-29873505430083027842016-06-28T13:24:47.287-05:002016-06-28T13:24:47.287-05:00This is one of my favourite posts on this blog, th...This is one of my favourite posts on this blog, thanks Steve for sharing, great case and well explained. Jason Lee Winterhttps://www.blogger.com/profile/15234259550852349847noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-47879882735587528802016-06-28T06:34:20.197-05:002016-06-28T06:34:20.197-05:00Thierala’s Algorithm is the best way to guess the ...Thierala’s Algorithm is the best way to guess the culprit single vessel critical STEMI. Flahttps://www.blogger.com/profile/07720331407971891646noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-20914722986440686052014-11-17T13:14:48.555-06:002014-11-17T13:14:48.555-06:00Just seeing this now - GREAT POST and explanation ...Just seeing this now - GREAT POST and explanation by Dr. Smith! I'd venture an opinion on the above question about leads with "highest amount of ST elevation" pointing to the infarct-related artery. To me - the factors pointing to acute RCA occlusion are: i) Truly dramatic inferior ST elevation with amount of ST elevation in III > II; ii) Clear evidence of acute RV infarction (lots of ST elevation in V1 and V4R but not really in aVR); and iii) Much less ST elevation in V5,V6 than in lead III (the opposite would be seen with a dominant LCx occlusion). Sadanandan describes a mechanism from acute RCA occlusion with marked RV injury and dilatation as occasionally leading to a larger part of the RV free wall being directed anteriorly - leading to ST elevation no only in V1, but also in V2-thru-V4 - and that is what I'd guess is happening here (Sadanandan et al - Am Heart J 146:653-661, 2003). GREAT case!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-45110160206198610122014-11-15T07:36:57.492-06:002014-11-15T07:36:57.492-06:00There is probably some truth to that. Maybe ST to ...There is probably some truth to that. Maybe ST to R ratio would help in localizing.<br />Steve SmithSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-57379505141572814842014-11-15T06:51:11.946-06:002014-11-15T06:51:11.946-06:00Hi, very good case. I also thought of a dominant p...Hi, very good case. I also thought of a dominant prox RCA. One question: I once was told that in cases like this, the infarct artery often could be indicated by the leads with highest amplitude of STE. In this case, the inferior leads indicating RCA. Do you know this to be true? I suppose this is dependent on the qrs amplitudes of the affected leads as well.<br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-5928843645981644382014-11-14T16:35:47.037-06:002014-11-14T16:35:47.037-06:00good question, but I don't know the answer, so...good question, but I don't know the answer, sorry.<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-6865758248496809392014-11-14T15:48:02.936-06:002014-11-14T15:48:02.936-06:00Very nice case. I wonder how were the systolic fun...Very nice case. I wonder how were the systolic function of both ventricles and If it was some acute mitral regurgitation ! Anonymousnoreply@blogger.com