A 40-something woman with acute pulmonary edema -- see the Speckle Tracking echocardiogram.

A 49 year old woman with h/o COPD only presented with sudden dyspnea.  She had acute pulmonary edema on exam.  PrehospitalConventional algorithm interpretation: ANTERIOR INFARCT, STEMITransformed ECG by PM Cardio:PM Cardio AI Bot interpretation:OMI with High ConfidenceWhat do you think?There is STE and hyperacute T-waves in V2 and V3, with significant STE in I and aVL, and inferior reciprocal STD.This is proximal LAD Occlusion until proven otherwise.On arrival, lung ultrasound confirmed pulmonary edema (B lines).  An ECG was recorded:ED ECG 1:The findings are still present but not nearly as profound now. Conventional algorithm interpretation:SINUS TACHYCARDIAABNORMAL RHYTHM ECGConfirmed by over-reading physicianTransformed ECG by PM Cardio:PM Cardio interpretation:OMI with Low ConfidenceDr. Rob Reardon did a bedside echo usingSpeckle tracking.  Speckle Tracking tracks the endocardium for excellent visualization of wall motion abnormalities, and graphs the wall motion for each major segment. (see graphs)  Speckle Tracking Video This shows apical ballooning, which can be due to takotsubo, or to an LAD Occlusion (especially a proximal LAD with wraparound to inferior wall, such that the anterior, lateral, and inferior walls are ischemic, which will also lead to apical ballooning).  Example here: DIffuse ST Elevation with Apical Ballooning: is it Takotsubo Stress Cardiomyopathy?The ECG and echo could be due to either...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs