Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. Echo showed new anterior regional wall motion abnormality and decrease EF from 60% to 45%. Clin Cardiol 2022 4.

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Dr. Smith's ECG Blog

JULY 31, 2020

The finding of dynamic ST-T wave changes on serial tracings in association with a change in chest pain symptoms ( SEE My Comment in the July 21, 2020 post ). Any ST elevation in inferior leads that occurs in association with mirror-image opposite ST depression in lead aVL. ST depression that is maximal in leads V2-to-V4.

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Dr. Smith's ECG Blog

FEBRUARY 15, 2018

She went on to describe her chest pain as a "buffalo sitting on my chest" and a "weird" sensation in her jaw for 1 hour prior to arrival, associated with lightheadedness and diaphoresis. The patient was given fentanyl initially for chest pain with minimal effect and then vomited which was followed by zofran and famotidine.

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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. All electrocardiograms (ECGs) and coronary angiograms were blindly analyzed by experienced cardiologists.

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Dr. Smith's ECG Blog

DECEMBER 15, 2023

The patient contacted EMS after a few hours of chest pain that started 5:30 AM. The pain was described as 6/10 radiating to the right shoulder. The chest pain was described as both sharp and pressure like. Below is the post -PCI electrocardiogram. He is otherwise healthy.

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Dr. Smith's ECG Blog

DECEMBER 5, 2022

Acute chest pain and a bizarre ECG Bizarre (Hyperacute??) Electromechanical association: a subtle electrocardiogram artifact. Incredibly , this case was just published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) 2018; 137: 402-404. 2018; 137: 402-404. What do you think?

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Dr. Smith's ECG Blog

DECEMBER 27, 2018

A Deep Neural Network learning algorithm outperforms a conventional algorithm for emergency department electrocardiogram interpretation. But lead V2 has a worrisome amount of ST elevation, and in a chest pain patient, I would be worried about STEMI. I do research on Cardiologs' algorithm: Smith SW et al. What an honor.

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Dr. Smith's ECG Blog

FEBRUARY 6, 2020

male with a history of HTN and ETOH developed squeezing epigastric abdominal pain with associated vomiting and diaphoresis, followed by a syncopal episode which lasted about 10 seconds. When medics arrived, he denied any chest pain, shortness of breath, or palpitations prior to the syncopal episode.

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EMS 12-Lead

MAY 20, 2022

Cardiology felt her chest pain to be, most likely, the result of coronary supply-demand mismatch in the context of HCM endothelial remodeling (i.e. New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Below are two examples of this. 40; 1234-1241.

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

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Dr. Smith's ECG Blog

JULY 22, 2023

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.

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Dr. Smith's ECG Blog

OCTOBER 9, 2018

The utility of the triage electrocardiogram for the detection of ST-segment elevation myocardial infarction. October 2018. We record ECGs in triage on every patient with chest pain, and some other indications, and this amounts to 8000 ECGs in triage each year, costing at most $200,000 (8000 x $20.00).

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Dr. Smith's ECG Blog

JUNE 2, 2023

She denied chest pain and denied feeling any palpitations, even during her triage ECG: What do you think? 1211-1212 CrossRef View Record in Scopus Google Scholar 2 FI Marcus, W Zareba The electrocardiogram in right ventricular cardiomyopathy/dysplasia. J Electrocardiol, 42 (2009), pp.

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Dr. Smith's ECG Blog

MARCH 6, 2019

A middle-aged woman with history of hypertension presented to another hospital approximately 2 hours after onset of chest pain and shortness of breath. Early Continuous ST Segment Monitoring in Unstable Angina: Prognostic Value Additional to the Clinical Characteristics and the Admission Electrocardiogram. mm STE in V1 and 1.5-2.0

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Dr. Smith's ECG Blog

JANUARY 30, 2019

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.

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Dr. Smith's ECG Blog

DECEMBER 5, 2019

The patient denied any chest pain whatsoever, and a troponin at zero and 2 hours were both undetectable. Fever not only unmasks a Brugada-type electrocardiogram (ECG) but also increases the risk of ventricular tachyarrhythmias such as ventricular fibrillation (VF) or sudden cardiac death. Heart Rhythm 2018.

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