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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 chestpain and shortness of breath after finishing a 4-mile run. Exercise test would also have been reasonable. Read about "exercise induced cardiac troponin elevations" here.
Written by Jesse McLaren, with comments from Smith and Grauer A 60 year old presented with three weeks of intermittent non-exertional chestpain without associated symptoms. A prospective validation of the HEART score for chestpain patients at the emergency department. American Journal of Emergency Medicine 2022 4.
Because the patient was exercising, which increases sympathetic tone, facilitating AV conduction. Why did today's patient develop AFlutter while exercising on a treadmill? Does Exercise Induce Non-Sinus Tachyarrhythmias? But how can the AV node conduct at a rate of 280? Why such rapid AV conduction?
The history is concerning ( This patient was awakened from sleep by chestpain that persisted for several hours — on a background of intermittent CP in recent weeks ). The ECG changes seen between the initial ECG and the repeat ECG after NTG — are undeniable! Nor was there a challenge to look for coronary spasm.
Written by Willy Frick A 50 year old man with no medical history presented with acute onset substernal chestpain. His ECG is shown below. Pretty obvious anterior current of injury. This was a machine read STEMI positive OMI. Readers of this blog can easily appreciate the hyperacute T waves in the precordium, clearest in V1-V4.
24: Joint American College of Cardiology/Journal of the American College of Cardiology Late-Breaking Clinical Trials (Session 402) Saturday, April 6 9:30 – 10:30 a.m.
This is one case where it made a difference: Right Ventricular MI seen on ECG helps Angiographer to find Culprit Lesion Nevertheless, it is sometimes a fun academic exercise to try to predict the infarct artery: An elderly patient had onset of chestpain one hour prior. He called 911. Here is the prehospital ECG.
See these similar cases: A man in his sixties with chestpain Why is there inferior ST elevation, and would you get posterior leads? For readers not familiar with this format — I've reviewed its features in the Addendum at the bottom of the page in the April 24, 2022 post in Dr. Smith's ECG Blog. Is it inferior and RV OMI?
She did notice something slightly wrong subjectively, but had no palpitations, chestpain, or SOB, or any other symptom. Vagally-mediated AFib is more likely to occur at night or after meals — and less likely to occur with exercise. 25, 2022 ). Her Apple Watch suddenly told her that she is in atrial fibrillation.
He had concurrent sharp substernal chestpain that resolved, but palpitations continued. Over past 3 months, he has had similar intermittent episodes of sharp chestpain while running, but none at rest. A 50-something presented with s udden onset palpitations 8 hrs prior while sitting at desk at work.
She denied chestpain and denied feeling any palpitations, even during her triage ECG: What do you think? She was given some intense exercise restrictions and offered genetic testing. For review of a case of RVOT VT — Please see My Comment at the bottom of the page in the February 14, 2022 post in Dr. Smith's ECG Blog.
Share ChestPain Symptoms There is no role for CT Calcium Scoring in the setting of someone with chestpain symptoms suspected to be from a narrowed coronary artery. This approach also reduces death from heart disease and heart attacks by 41% compared to conventional approaches such as exercise stress testing 2.
His medical history is unremarkable except a similar pain occurred 4-5 times in the previous 3 months with less intensity, short duration, unrelated to exertion. He visited an outpatient clinic for it and an echocardiogram and exercise stress test was normal. He has 40 packs-year of smoking history. He denies taking any medication.
1:42 AM ∙ Dec 10, 2022 76 Likes 6 Retweets The “mild & self-resolved” moniker refers to the experience of patients hospitalized for vaccine myocarditis. They admitted to it themselves, and they still used it. One of the 2 cases described in the New England Journal of Medicine was diagnosed based on autopsy findings.
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