Remove 2012 Remove Chest Pain Remove Ischemia
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A Middle-Aged male with Chest Pain and an Unusual ECG

Dr. Smith's ECG Blog

The patient presented with chest pain. Followup ECG: No Change Absence of evolution is the best evidence against ischemia as the etiology. I was taught that the tell-tale sign of ischemia vs an electrical abnormality was in the hx, i.e. chest pain for the ischemia and potential syncope for brugada.

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A man in his 70s with acute chest pain and paced rhythm.

Dr. Smith's ECG Blog

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 chest pain. Annals of Emergency Medicine 2012; 60(12):766-776. EKG shown here: LAFB with no clear signs of OMI or ischemia.

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Normal angiogram one week prior. Must be myocarditis then?

Dr. Smith's ECG Blog

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. The ECG does not show any definite signs of ischemia. The below ECG was recorded.

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Do you need to be a trained health care professional to diagnose subtle OMI on the ECG?

Dr. Smith's ECG Blog

He interprets here: "This EKG is diagnostic of right bundle branch block and transmural ischemia of the anterior wall, most likely from an occlusion of the proximal LAD. The patient had continued to have chest pain. By the summer of 2012, he could read an ECG for OMI better than any doctor I knew.

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Right precordial ST depression in a patient with chest pain

Dr. Smith's ECG Blog

A 70-year-old man calls 911 after experiencing sudden, severe chest pain. Computer read: "Non-specific ST abnormality, consider anterior subendocardial ischemia" There are very poor R-waves in V1-V4 suggesting old anterior MI. Firstly, subendocardial ischemia does not localize on 12-Lead ECG. Neth Heart J. O'Gara et al.

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Is this Acute Ischemia? More on LVH.

Dr. Smith's ECG Blog

A middle aged male presented with chest pain. There may be ischemia present, but it is not evident on the ECG. In LVH, T-wave inversions are usually much more assymetric , like these (Figure 2): Acute Chest pain, but baseline ECG. October 1, 2012; Volume 110, Issue 7, Pages 977–983. Birnbaum Y and Mahboob A.

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Should we activate the cath lab? A Quiz on 5 Cases.

Dr. Smith's ECG Blog

All of the patients presented with chest pain , and they are all in triage. Remember, in diffuse subendocardial ischemia with widespread ST-depression there may b e ST-E in lead s aVR and V1. There are well formed R-waves with good voltage/amplitude which is uncommon for ischemia. True Positive ECG#2 : Also sinus rhythm.

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