Remove 2019 Remove Diabetes Remove STEMI
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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

Case submitted and written by Mazen El-Baba MD, with edits from Jesse McLaren and edits/comments by Smith and Grauer A 90-year old with a past medical history of atrial fibrillation, type-2 diabetes, hypertension, dyslipidemia, presented with acute onset chest/epigastric pain, nausea, and vomiting. Am J Med 2019, 132(5):622-630.

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Concerning EKG with a Non-obstructive angiogram. What happened?

Dr. Smith's ECG Blog

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. From My Comment in the November 14, 2019 post in Dr. Smith's ECG Blog: A subject well worth periodic review — is the concept of Terminal QRS Distortion ( T-QRS-D ).

Plaque 123
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Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

His medical history includes hypertension, a decade-long battle with diabetes, ischemic heart disease, a coronary bypass graft surgery ten years ago, a diagnosis of congestive heart failure for the last five years, and a prior ICD implantation five years ago. That was also my initial concern. No "baseline" ECG is available for comparison.

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Extreme shock and cardiac arrest in COVID patient

Dr. Smith's ECG Blog

Higher troponin correlated with more history of heart failure, diabetes, and hypertension, as well as higher D-dimer, and nearly all inflammatory markers. In a series of 18 patients with COVID and ST elevation, 8 were diagnosed with STEMI, 6 of whom had an angiogram and it showed obstructive coronary disease. Median age was 66.4

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A man in his 50s with "gas pain"

Dr. Smith's ECG Blog

Written by Pendell Meyers, sent by Anonymous A man in his 50s with history of type 2 diabetes, HTN, and HLD presented with one day of off and on chest / upper abdominal pain. Some patients will not progress (or not as quickly) to obvious STEMI, as in this case. Vitals were within normal limits.

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Hyperkalemia

EMS 12-Lead

The attending crews were concerned for SVT with corresponding ischemic hyperacute T waves (HATW) and subsequently activated STEMI pre-hospital. In today’s case the patient is suffering from diabetic ketoacidosis, which facilitates hydrogen ion shift into the cells in exchange for potassium. Elsevier-Saunders: Philadelphia, PA. [6].

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Interventionalist at the Receiving Hospital: "No STEMI, no cath. I do not accept the transfer."

Dr. Smith's ECG Blog

Are Some Cardiologists Really Limited by Strict Adherence to STEMI millimeter criteria? I was texted these ECGs by a recent residency graduate after they had all been recorded, along with the following clinical information: A 50-something with no cardiac history, but with h/o Diabetes, was doing physical work when he collapsed.

STEMI 52