Remove 2009 Remove Chest Pain Remove Pulmonary
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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. The patient was transported to the CCU for further medical optimization where a pulmonary artery catheter was placed. NEJM 362(9):779; March 4, 2009.

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Large Transmural STEMI with Myocardial "Rupture" of Ventricular Septum

Dr. Smith's ECG Blog

A man in his 60's presented after 4 days of chest pain, with some increase of pain on the day of presentation. Exact pain history was difficult to ascertain. Apr 28, 2009. There was some SOB. He had walked into the ED (did not use EMS). Here is his ECG: There is atrial fibrillation at a rate of 95.

STEMI 52
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Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Dr. Smith's ECG Blog

A man in his 60's presented after 4 days of chest pain, with some increase of pain on the day of presentation. Exact pain history was difficult to ascertain. Apr 28, 2009. There was some SOB. He had walked into the ED (did not use EMS). He was in no distress and vital signs were normal. Obviously there is MI.

STEMI 52
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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? CXR confirmed bilateral pulmonary edema and bilateral small effusions. J Electrocardiol, 42 (2009), pp. Despite otherwise normal vital signs, she was appropriately triaged to the critical care area of the ED.

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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.