AFIB Chest Pain Ischemia 
Dr. Smith's ECG Blog
DECEMBER 26, 2023
I went to the patient's chart: Elderly woman with stuttering chest pain and SOB, and dizziness. The unique " shape " of the prominent ST-T wave abnormalities in this tracing — that are much more suggestive of some significant form of LVH ( L eft V entricular H ypertophy ) rather than ischemia. What do you think now?
Ken Grauer, MD
FEBRUARY 18, 2023
The presenting complaint was chest pain — and the patient collapsed soon after arrival in the ED. These findings suggest that instead of VT — the rhythm in Figure-1 is AFib with a fairly rapid ventricular response. Since the rhythm is supraventricular (ie, AFib ) — we can accurately assess QRS morphology.
Dr. Smith's ECG Blog
JULY 14, 2024
Sent by anonymous, written by Pendell Meyers Case 1: A man in his 50s presented with acute chest pain. Click here to sign up for Queen of Hearts Access Case 2: A woman in her 60s presented with acute chest pain. Normal vital signs. Here is his ECG at triage: What do you think? Normal vitals. What do you think?
Dr. Smith's ECG Blog
SEPTEMBER 24, 2023
A 50 something male was seen in the emergency room due to typical chest pain. The pain had started the same day about two hours prior to medical contact. The medical care providers ascribed the patient's chest pain to new onset atrial fibrillation with rapid ventricular response after having viewed the ECG.
Dr. Smith's ECG Blog
MARCH 15, 2023
She did notice something slightly wrong subjectively, but had no palpitations, chest pain, or SOB, or any other symptom. I focus my comment on a few additional aspects regarding new AFib. The Importance of History: We are told that today’s patient is an otherwise healthy woman — who presented to the ED for new AFib.
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. His response: “subendocardial ischemia. Anything more on history? J Electrocardiol 2013;46:240-8 2.
Dr. Smith's ECG Blog
FEBRUARY 6, 2024
Chest trauma was suspected on initial exam. The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Gunshot wound to the chest with ST Elevation Would your radiologist make this diagnosis, or should you record an ECG in trauma? ST depression. Myocardial Contusion?
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