Dr. Smith's ECG Blog
MAY 21, 2023
Whenever a patient does not have chest pain, the pre-test probability of OMI is diminished. Of course SOB, jaw pain, shoulder pain, etc can be a result of OMI, but the pretest probability is less and so you must scrutinize further. Here is the first ED ECG: COMPUTER INTERPRETATION: Electronic Atrial Pacemaker.
Dr. Smith's ECG Blog
JUNE 5, 2024
The patient presented due to chest pain that was typical in nature, retrosternal and radiating to the left arm and neck. He denied any exertional chest pain. It is unclear if the patient was pain free at this time. He has a medical hx notable for hypertension, hyperlipidemia and previous tobacco use disorder.
Dr. Smith's ECG Blog
MAY 5, 2024
He learned more about the patient: A 77 year old female with a past medical history of hypertension and hyperlipidemia presented to the ED at around 0520 after waking up at 0400 with 10/10 chest heaviness radiating to both arms. The patient had continued to have chest pain. He was a paramedic at the time.
Dr. Smith's ECG Blog
AUGUST 3, 2017
A 70-year-old man calls 911 after experiencing sudden, severe chest pain. 2012 Sep;45(5):463-75. Does routine use of the 15-lead ECG improve the diagnosis of acute myocardial infarction in patients with chest pain? This case comes from Sam Ghali ( @EM_RESUS ). Thanks, Sam! O'Gara et al. Circulation. Am J Cardiol.
Dr. Smith's ECG Blog
DECEMBER 27, 2023
Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. The following ECG was obtained.
Dr. Smith's ECG Blog
JANUARY 2, 2016
A middle aged male presented with chest pain. In LVH, T-wave inversions are usually much more assymetric , like these (Figure 2): Acute Chest pain, but baseline ECG. And sometimes the lateral T-wave is biphasic, with the terminal portion more upright (Figure 3): Acute chest pain. Baseline EKG, no MI.
Dr. Smith's ECG Blog
MAY 23, 2014
This patient presented with a mechanical fall and had chest pain. His chest pain increased and this ECG was recorded: Now there is increasing inferior ST elevation. Severe Left Main disease, and chest pain with contrast injection into the LM. This case shows a CT image of subendocardial ischemia.
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