Remove 2013 Remove Chest Pain Remove Electrocardiogram
article thumbnail

A man in his early 40s with chest pain a "normal ECG" by computer algorithm. Should we avoid interrupting a physician to interpret his ECG?

Dr. Smith's ECG Blog

Written by Pendell Meyers A man in his early 40s experienced acute onset chest pain. The chest pain started about 24 hours ago, but there was no detailed information available about whether his pain had come and gone, or what prompted him to be evaluated 24 hours after onset. Am J Emerg Med. 2022 Jan;51:384-387.

article thumbnail

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. Acute myocardial infarction with isolated ST-segment elevation in posterior chest leads V7-V9: "hidden" ST-elevations revealing acute posterior infarction. This case comes from Sam Ghali ( @EM_RESUS ). Thanks, Sam! J Am Coll Card 1999; 34:748-753.

article thumbnail

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chest pain to Dr. McLaren. All electrocardiograms (ECGs) and coronary angiograms were blindly analyzed by experienced cardiologists.

article thumbnail

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. Triage ECG: What do you think? This is diagnostic of proximal LAD occlusion. This is a huge anterolateral OMI. I cannot be anything else.

article thumbnail

A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

He denied chest pain or shortness of breath. In the clinical context of weakness and fever, without chest pain 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.

article thumbnail

How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. Updates on the Electrocardiogram in Acute Coronary Syndromes.

article thumbnail

Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

It was from a patient with chest pain: 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.