Remove 2009 Remove Chest Pain Remove STEMI
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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.

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75 year old with 24 hours of chest pain, STEMI negative

Dr. Smith's ECG Blog

Written by Jesse McLaren A 75 year old with a history of CABG called EMS after 24 hours of chest pain. The patient has a history of CABG so some of these changes could be old, but with ongoing chest pain and bradycardia in a high risk patient this is still acute OMI until proven otherwise. HR 40, BP 135/70, RR16, O2 100%.

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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. Thus, this is BOTH an anterior and inferior STEMI in the setting of RBBB. How old is this antero-inferior STEMI? Apr 28, 2009. How acute is it?

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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. of patients with anterior STEMI, ST elevation of greater than or equal to 3.0

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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. There is no ST elevation.

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

Dr. Smith's ECG Blog

Although the patient reported experiencing mild pressure-like chest pain, there was suspicion among clinicians that this might be indicative of an older change. There is some ST-segment elevation in DII, DIII, aVF, V4-6. Due to the observed ST-segment elevation, the medical team expressed immediate concern.

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From The Vault: RBBB

EMS 12-Lead

Original publication date July, 2009. Generally speaking, right bundle branch block does not mimic, or obscure, the ECG diagnosis of acute STEMI the way left bundle branch block does. Case Review EMS is called to the residence of a 69 y/o M with a chief complaint of chest pain. An ECG is captured.