Dr. Smith's ECG Blog

OCTOBER 17, 2024

Written by Jesse McLaren Two patients in their 70s presented to the ED with chest pain and RBBB. Patient 1 : a 75 year old called paramedics with one day of left shoulder pain which migrated to the central chest, which was worse with deep breaths. Do either, both, or neither have occlusion MI? Vitals were normal.

Chest Pain 72

Chest Pain STEMI Pulmonary Embolism 72

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

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. Thirty-six patients (36%) presented with cardiac arrest, and 78% (28/36) underwent emergent angiography.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Ken Grauer, MD

OCTOBER 27, 2023

Given the history of dyspnea on exertion over a several week period ( but no mention of chest pain ) — and — the finding of deep, symmetric T wave inversion in the anterior leads ( as per Pearl #2 ) — it is possible that the onset of her symptoms is the result of a "Silent MI" ( See ECG Blog #228 for more on "Silent" MI ). . =

Blog 101

Blog Pacemaker Bradycardia Arrhythmia 101

Dr. Smith's ECG Blog

JULY 22, 2023

Written by Pendell Meyers A man in his 70s with no cardiac history presented with acute weakness, syncope, and fever. 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.

Chest Pain 92

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 92