Remove 2015 Remove Chest Pain Remove Myocardial Infarction
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Texted from a former EM resident: 70 yo with syncope and hypotension, but no chest pain. Make their eyes roll!

Dr. Smith's ECG Blog

No Chest Pain, but somnolent. The fact that this is syncope makes give it a far lower pretest probability than chest pain, but it was really more than syncope, as the patient actually underwent CPR and had hypotension on arrival of EMS. The American Journal of Emergency Medicine 2015; 33(6):786-790.

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A man in his 50s with chest pain

Dr. Smith's ECG Blog

Sent by anonymous, written by Pendell Meyers A man in his 50s with no prior known medical history presented to the Emergency Department with severe intermittent chest pain. He denied any lightheadedness, shortness of breath, vomiting, or abdominal pain. Isn't it amazing?? Pol Arch Intern Med. 2017;127:401–411. Circulation.

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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. American Heart Journal 170(6):1255-1264; December 2015. Triage ECG: What do you think? This is diagnostic of proximal LAD occlusion.

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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. 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.

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Chest pain, a ‘normal’ ECG, a 'normal trop', and low HEART and EDACS scores: Discharge home? Stress test? Many errors here.

Dr. Smith's ECG Blog

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. Lancet 2015 6. Int J Cardiol 2013 2.

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Acute OMI or "Benign" Early Repolarization?

Dr. Smith's ECG Blog

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. The following ECG was obtained.

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A 50-something with 5 hours of typical chest pain and Left Bundle Branch Block

Dr. Smith's ECG Blog

A 50-something male who is healthy and active with no previous medical history presented with 5 hours of continuous worrisome chest pain. Chest pain with New LBBB: It helps to actually measure the ST/S ratio A Fascinating Demonstration of ST/S Ratio in LBBB and Resolving LAD Ischemia The cath lab was activated.