Remove Aneurysm Remove Article Remove Chest Pain
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Chest pain and a computer ‘normal’ ECG. Therefore, there is no need for a physician to look at this ECG.

Dr. Smith's ECG Blog

Written by Jesse McLaren, comments by Smith A 55 year old with a history of NSTEMI presented with two hours of exertional chest pain, with normal vitals. Smith : Old inferior MI with persistent ST Elevation ("inferior aneurysm") has well-formed Q-waves. What do you think?

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Chest pain with NonDiagnostic ECG but Diagnostic CT Scan

Dr. Smith's ECG Blog

An elderly woman presented with chest pain that radiated to the back for several hours. The first troponin returned at 0.099 ng/mL (elevated, consistent with Non-Occlusion MI) Providers were concerned with aortic dissection, so they order a chest aorta CT. Here is here initial ECG: There is only a nonspecific flat T-wave in aVL.

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Is this acute STEMI? LV Aneurysm? Would you give Thrombolytics?

Dr. Smith's ECG Blog

This case was recently posted by Tyron Maartens on Facebook EKG club (he agreed to let me post it here), with the following clinical information: "42 year old male with two weeks of intermittent chest discomfort, awoke 4 hours prior to this ECG with a more severe, heavy chest pain (5/10). BP 112/80, SpO2 100%. It is not chronic.

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H/o MI and stents with brief angina has this ED ECG. And what is Fractional Flow Reserve?

Dr. Smith's ECG Blog

Although diagnostic of MI, it is highly suspicious for " Old inferior MI with persistent ST Elevation" or "inferior aneurysm morphology" because of the well-formed Q-waves and the flat T-waves. To repeat: in contrast, anterior aneurysm is much more easily distinguished from acute MI due to the QS-waves. There are well-formed Q-waves 3.

Angina 52
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Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused

Dr. Smith's ECG Blog

Persistent ST elevation 3 days after a nearly transmural MI portends possible LV aneurysm. This 42 yo diabetic male presented with cough and foot pain. Symptoms have been prolonged but intermittent, and there has been little chest pain, if any. He had been awakened by cough at 3 AM 2 days earlier.

STEMI 52
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A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

These are all findings that can be expected with left ventricular aneurysm. Many advances in treatment have occurred in the 28 years since this article was published. That said — misdiagnosis of WCT rhythms for the same reasons cited by the authors remains all-too-common — so the lessons put forth in this 1995 article remain relevant.

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A young patient with diminishing pain with a subtle but diagnostic ECG.

Dr. Smith's ECG Blog

Case A 39-year-old male without prior medical history presents with chest pain that started 2 hours prior to presentation. He says that the pain intensity was 10/10 at home but now about 4/10. Despite the clinical stability and decreasing pain, this patient needs an immediate angiogram. Here are his publications.)