2013 Chest Pain Myocardial Infarction 
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. Why is there this notion that myocardial infarction cannot be diagnosed in the setting of ventricular paced rhythm?
Dr. Smith's ECG Blog
MAY 23, 2023
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.
Dr. Smith's ECG Blog
APRIL 22, 2022
Written by Jesse McLaren, with comments from Smith and Grauer A 60 year old presented with three weeks of intermittent non-exertional chest pain without associated symptoms. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol 2013 2. Shin YS, Ahn S, Kim YJ.
Dr. Smith's ECG Blog
MAY 6, 2019
The patient presented with chest pain. 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. Only 5-18% of ED patients with chest pain have a myocardial infarction of any kind.
Dr. Smith's ECG Blog
AUGUST 3, 2017
A 70-year-old man calls 911 after experiencing sudden, severe chest pain. Electrocardiographic Manifestations: Acute posterior wall myocardial infarction. Posterior myocardial infarction: the dark side of the moon. This case comes from Sam Ghali ( @EM_RESUS ). Thanks, Sam! J Emerg Med 2001; 20:391-401.
Dr. Smith's ECG Blog
JUNE 1, 2022
A 40-something male with no previous cardiac disease presented with chest pain. The pain continued and the first high sensitivity troponin I returned at 105 ng/L Another ECG was recorded: The ST segment in aVF has flattened a bit, revealing that there is some STD in addition to the non-specific findings in III and aVL.
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
A 70-something female with no previous cardiac history presented with acute chest pain. She awoke from sleep last night around 4:45 AM (3 hours prior to arrival) with pain that originated in her mid back. She stated the pain was achy/crampy. Over the course of the next hour, this pain turned into a pressure in her chest.
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