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A 70-year-old man calls 911 after experiencing sudden, severe chestpain. Common pitfalls in the interpretation of electrocardiograms from patients with acute coronary syndromes with narrow QRS: a consensus report. 2012 Sep;45(5):463-75. This case comes from Sam Ghali ( @EM_RESUS ). Thanks, Sam! O'Gara et al. Circulation.
Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chestpain. Annals of Emergency Medicine 2012; 60(12):766-776. Triage ECG: What do you think? This is diagnostic of proximal LAD occlusion.
He denied chestpain or shortness of breath. In the clinical context of weakness and fever, without chestpain or shortness of breath, the likelihood of Brugada pattern is obviously much higher. Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. PM Cardio digitized version.
She denied chestpain 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.
A 36 yo male smoker presented to the ED with chestpain. 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. Wong, 2012) STE in aVR of at least 0.5 Wong, 2012) STE in aVR of at least 0.5
It was from a patient with chestpain: Note the obvious Brugada pattern. Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. The elevated troponin was attributed to either type 2 MI or to non-MI acute myocardial injury. There is no further workup at this time. This patient ruled out for MI.
J Electrocardiology 45 (2012):433-442. The patient denied any chestpain whatsoever, and a troponin at zero and 2 hours were both undetectable. Fever not only unmasks a Brugada-type electrocardiogram (ECG) but also increases the risk of ventricular tachyarrhythmias such as ventricular fibrillation (VF) or sudden cardiac death.
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