Aneurysm Chest Pain Ischemia 
Dr. Smith's ECG Blog
NOVEMBER 26, 2015
52-year-old lady presents to the Emergency Department with 2 hours of chest pain, palpitations & SOB. However, old MI w/aneurysm morphology (persistent ST-Elevation) can look just like this. Ischemic Hyperacute T waves (Tall, round, symmetric, vs the “pointy” peaked-T’s of HyperK), are often a clue to ischemia.
Dr. Smith's ECG Blog
JANUARY 6, 2023
Submitted and written by Anonymous, edits by Meyers and Smith A 50s-year-old patient with no known cardiac history presented at 0045 with three hours of unrelenting central chest pain. The pain was heavy, radiated to her jaw with an associated headache. Triage VS: 135/65 mmHg, 95 bpm, 94% on room air, 16/min, 98.6 mg/dL, K 3.5
Dr. Smith's ECG Blog
JANUARY 9, 2023
No prior exertional complaints of chest pain, dizziness, lightheadedness, or undue shortness of breath. He denied headache or neck pain associated with exertion. I sent this ECG to Dr. Smith, with the only information that it is a 17 year old with chest pain. 24 yo woman with chest pain: Is this STEMI?
Dr. Smith's ECG Blog
SEPTEMBER 27, 2019
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.
Dr. Smith's ECG Blog
NOVEMBER 17, 2014
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.
Dr. Smith's ECG Blog
JULY 31, 2013
A 20-something male presented from an outside facility with Chest pain. He came with this ECG from the outside facility, recorded 1 hour after pain onset: There is at least 2 mm of inferior ST elevation, with reciprocal ST depression in aVL, ST flattening in V4-V6, and T-wave inversion in V2. A coronary aneurysm was found.
Dr. Smith's ECG Blog
OCTOBER 26, 2010
This 54 year old patient with a history of kidney transplant with poor transplant function had been vomiting all day when at 10 PM he developed severe substernal crushing chest pain. He presented to the Emergency Department with a blood pressure of 111/66 and a pulse of 117. He had this ECG recorded.
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