2017 Bradycardia Chest Pain 
Dr. Smith's ECG Blog
NOVEMBER 3, 2017
J Electrocardiology 50(5):561-569; September/October 2017. This is the initial ED ECG of a 46 year old male with chest pain: The QTc was 420 ST Elevation at 60 ms after the J-point in lead V3 = 2.5 ng/ml) A 45 year old male called 911 for chest pain: The QTc was 400 ST Elevation at 60 ms after the J-point in lead V3 = 3.5
Dr. Smith's ECG Blog
JULY 21, 2024
The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. Written By Magnus Nossen — with edits by Ken Grauer and Smith. The below ECG was recorded.
EMS 12-Lead
JUNE 1, 2022
Smith and Myers found that in otherwise classic Wellens syndrome – that is, prior anginal chest pain that resolves with subsequent dynamic T wave inversions on the ECG – even the T waves of LBBB behave similarly. [2] 2] Although the clinical context in today’s case does not fit these descriptors for Type I OMI (e.g. 2] Meyers, H.
Dr. Smith's ECG Blog
NOVEMBER 24, 2017
The rule of thumb is less accurate, and the risk is higher because a long QT in the presence of bradycardia ("pause dependent" Torsades) predisposes to Torsades. 6) Use a different rule of thumb for bradycardia : Manually approximate both the QT and the RR interval. 3) At heart rates below 60, far more caution is due.
Dr. Smith's ECG Blog
JANUARY 30, 2019
It was from a patient with chest pain: Note the obvious Brugada pattern. For now, the 2017 AHA/ACC/HRS guidelines for asymptomatic patients that have inducible types of Brugada syndrome recommend observation without any specific therapies or interventions [8]. There is no further workup at this time.
Dr. Smith's ECG Blog
APRIL 8, 2015
Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. Frequent or repetitive PACs ii.
Dr. Smith's ECG Blog
DECEMBER 5, 2019
This is based on the Sieira et al, 2017, risk calculator , which gives a borderline risk score (2). Regardless of further evaluation, she should avoid bradycardia, AV nodal blockers, Na channel blockers, and fevers. --If The patient denied any chest pain whatsoever, and a troponin at zero and 2 hours were both undetectable.
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