Dr. Smith's ECG Blog

OCTOBER 18, 2023

The chest pain quickly subsided. Most such rhythms in the setting of ischemia are VF and will not convert without defibrillation. This distinction is more than academic — because both treatment and the response to therapy tend to be different with these 2 entities. Acute ischemia? Use of QT-prolonging drugs?

Cardiac Arrest 121

Cardiac Arrest Tachycardia Cardiomyopathy Bradycardia 121

Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

Sent by anonymous, edited by Pendell Meyers A man in his 50s with history only of hypertension presented with acute chest pain that started 45 minutes prior to presentation while doing yard work. Smith : the profound persistent STE suggests either persistent occlusion or " no reflow " with persistent downstream ischemia.

STEMI 77

STEMI Myocardial Infarction Ischemia Academic 77

Dr. Smith's ECG Blog

OCTOBER 6, 2023

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 chest pain one hour prior. He called 911. Here is the prehospital ECG.

Aneurysm 65

Aneurysm Chest Pain Cardiogenic Shock Blog 65

Dr. Smith's ECG Blog

APRIL 29, 2020

A recent similar case: A 40-something with chest pain. PEARL #2 — Distinction between PMVT vs Torsades is more than academic. Instead, antiarrhythmic drugs such as amiodarone or ß-blockers may be needed — and/or treatment targeted to correcting ischemia. Acute ischemia? Is this inferior MI?

Cardiac Arrest 52

Cardiac Arrest Defibrillator Ischemia Tachycardia 52

Dr. Smith's ECG Blog

JUNE 13, 2024

Click here to sign up for Queen of Hearts Access Case A 58-year-old woman presented to the ED with burning chest pain that started 2-3 hours earlier while sitting on a porch swing. V1 sits over both the RV and the septum, so transmural ischemia of either one with give OMI pattern in V1 and reciprocal STD in V5 and V6.

Chest Pain 91

Chest Pain Document STEMI Defibrillator 91

DAIC

APRIL 2, 2025

Dr. Stone is Director of Academic Affairs for the Mount Sinai Health System and Professor of Medicine (Cardiology) and Professor of Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai, and the study chair of the ECLIPSE trial. These results extend the strong recommendations from recent U.S.

Stent 40

Stent Stents Outcomes Coronary Angiogram 40

Dr. Smith's ECG Blog

MAY 3, 2024

When I was shown this ECG, I said it looks like such widespread ischemia that is might be a left main occlusion, or LM ischemia plus circumflex occlusion (high lateral and posterior OMI). Here are some cases of RBBB with LAFB: What is the Diagnosis in this 70-something with Chest Pain? There is STE in aVR.

Cardiogenic Shock 126

Cardiogenic Shock Cardiac Arrest Hospital Ischemia 126

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

The ECG is diagnostic of LAD occlusion (or even left main occlusion possibly), with the classic pattern of RBBB and LAFB with huge concordant STE in V1-V2, I, and aVL, with reciprocal depression in most other leads (and/or a component of subendocardial ischemia pattern). What is the Diagnosis in this 70-something with Chest Pain?

Chest Pain 52

Chest Pain Cardiogenic Shock Tachycardia Ischemia 52

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. There is no definite evidence of acute ischemia. (ie, The below ECG was recorded.

Arrhythmia 130

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 130

Dr. Anish Koka

MAY 16, 2023

This means that at every age, the probability a man complaining of chest pain has significant underlying coronary disease as a cause of this chest pain is much higher than a woman complaining of chest pain. Thanks for reading Dr. The data is overwhelming every way you can possibly look at it.

Chest Pain 52

Chest Pain Coronary Artery Disease Cancer Heart Attack 52

Dr. Smith's ECG Blog

MARCH 14, 2025

He contacted EMS due to acute onset chest pain and feeling unwell and fatigued. He subsequently developed worsening chest pain. This, in the context of worsening chest pain , is evidence of reocclusion of the infarct-related artery and active OMI in development. The below ECG was recorded. What do you think?

Chest Pain 105

Chest Pain STEMI Myocardial Infarction Ischemia 105

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). Evidence of acute ischemia (may be subtle) vii. Academic Emergency Medicine.,

Arrhythmia 52

Arrhythmia Outcomes Chest Pain Risk Factors 52