Dr. Smith's ECG Blog

MAY 6, 2019

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.

Chest Pain 52

Chest Pain STEMI Ischemia Myocardial Infarction 52

Dr. Smith's ECG Blog

MAY 8, 2023

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.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Pacemaker 52

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

Chest Pain 111

Chest Pain Blog Cardiac Arrest Cardiomyopathy 111

Dr. Smith's ECG Blog

MAY 5, 2024

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.

EKG Technician 118

EKG Technician Chest Pain Blog STEMI 118

Dr. Smith's ECG Blog

AUGUST 3, 2017

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.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Ischemia 52

Dr. Smith's ECG Blog

JANUARY 2, 2016

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.

Ischemia 52

Ischemia Chest Pain STEMI Myocardial Infarction 52

DAIC

JANUARY 3, 2024

Traditional methods of non-invasive ischemia testing (stress EKG , stress echo, SPECT , PET , direct-to-cath) can result in false negatives 20-30 percent of the time, which can lead to undetected disease, and false positives over 50 percent of the time, which can lead to unnecessary invasive procedures. Arbab-Zadeh, Heart Int 2012.

Coronary Artery Disease 59

Coronary Artery Disease Chest Pain Plaque Technology 59