Remove 2009 Remove Chest Pain Remove Electrocardiogram
article thumbnail

Which patient has the more severe chest pain?

Dr. Smith's ECG Blog

2 middle aged males presented with chest pain. Which had the more severe chest pain at the time of the ECG? Patient 2 at the bottom with a very subtle OMI complained of 10/10 chest pain at the time the ECG was recorded. 414 patients were included in the analysis.

article thumbnail

Precordial ST depression. What is the diagnosis?

Dr. Smith's ECG Blog

A middle aged male with no h/o CAD presented with one week of crescendo exertional angina, and had chest pain at the time of the first ECG: Here is the patient's previous ECG: Here is the patient's presenting ED ECG: There is isolated ST depression in precordial leads, deeper in V2 - V4 than in V5 or V6. Blackwell Publishing 2009.

STEMI 52
article thumbnail

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

An initial electrocardiogram (ECG) is provided below. Although the patient reported experiencing mild pressure-like chest pain, there was suspicion among clinicians that this might be indicative of an older change. The patient was promptly admitted to the hospital for further evaluation. What do you think? What is the rhythm?

article thumbnail

A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!

Dr. Smith's ECG Blog

She denied chest pain and denied feeling any palpitations, even during her triage ECG: What do you think? 1211-1212 CrossRef View Record in Scopus Google Scholar 2 FI Marcus, W Zareba The electrocardiogram in right ventricular cardiomyopathy/dysplasia. J Electrocardiol, 42 (2009), pp.

article thumbnail

Septal STEMI with ST elevation in V1 and V4R, and reciprocal ST depression in V5, V6

Dr. Smith's ECG Blog

A 36 yo male smoker presented to the ED with chest pain. It had started the night before as "indigestion" and had progressed to 8/10 substernal chest pressure radiating to the right shoulder/jaw associated with diaphoresis, nausea, and SOB. 2009) similarly found that STE in aVR correlated with proximal (vs.

STEMI 52
article thumbnail

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Arch Intern Med 2009 Jul 27; 169:1262. Arch Intern Med 2009 Jul 27; 169:1305.