Remove AFIB Remove Embolism Remove Pericarditis
article thumbnail

A woman in her 40s with acute chest pain and shortness of breath

Dr. Smith's ECG Blog

Smith : This is classic for pulmonary embolism (PE). Acute pulmonary embolism was confirmed on CT angiogram: The patient did well. See our other acute right heart strain / pulmonary embolism cases: A man in his 50s with shortness of breath Another deadly triage ECG missed, and the waiting patient leaves before being seen.

article thumbnail

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

The morphology of V2-V4 is very specific in my experience for acute right heart strain (which has many potential etiologies, but none more common and important in EM than acute pulmonary embolism). CT angiogram showed extensive saddle pulmonary embolism. He had multiple cardiac arrests with ROSC regained each time. This is a quiz.

article thumbnail

Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

The "flu-like" illness suggests myo- or pericarditis, but that would be a diagnosis of exclusion. Then, part of the thrombus embolized into the LCx causing an inferoposterolateral OMI. (As Do not wait for the troponin; a lot of myocardium will be dead if you do. The case continues. Smith's ECG Blog that I have not yet included here. ).