2019 Chest Pain Coronary Angiogram 
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.
Dr. Smith's ECG Blog
JUNE 19, 2024
Case An 82 year old man with a history of hypertension presented to the ED with chest pain at 1211. He described his chest pain as pleuritic and reported that it started the day prior while swinging a golf club. The ED provider ordered a coronary CT scan to assess the patient for CAD. In lead I, about 1.5
Dr. Smith's ECG Blog
MAY 16, 2023
Sent by Dan Singer MD, written by Meyers, edits by Smith A man in his late 30s presented with acute chest pain and normal vitals except tachycardia at about 115 bpm. Dr. Singer sent this to me with just the information: "~40 year old with acute chest pain". Anxiety is a common cause of chest pain with tachycardia.
Dr. Smith's ECG Blog
MAY 19, 2022
Written by Pendell Meyers, edits by Smith and Grauer A man in his late 20s with history of asthma presented to the ED with a transient episode of chest pain and shortness of breath after finishing a 4-mile run. Ct coronary angiogram showed normal coronary arteries. International Journal of Cardiology 2019.
Ken Grauer, MD
FEBRUARY 24, 2023
Hospital evaluation for this patient was negative for an acute coronary syndrome ( ie, CT coronary angiogram was normal — troponin was not elevated — and Echo was negative, with no sign of pericardial effusion ). I interpreted the ECG in Figure-1 as follows: The rhythm is sinus at ~65/minute.
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. Incidence of an acute coronary occlusion. Am J Med 2019, 132(5):622-630. link] Harhash AA et al.
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. Type II MI), however decided to pursue coronary angiogram out of an abundance of caution. Below are two examples of this. References Naidu, S. Tower-Rader, A.
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