Aneurysm, Chest Pain and Pulmonary - Cardiovascular Update

Case Report: Surgical management of idiopathic pulmonary aneurysms and review surgical approaches

Frontiers in Cardiovascular Medicine

DECEMBER 19, 2023

Idiopathic pulmonary aneurysm is a clinically rare condition characterized by an unknown etiology and episodic occurrence. Despite its rarity, idiopathic pulmonary artery aneurysm poses potential risks to patients. Subsequently, she underwent surgical treatment.

Aneurysm

Aneurysm Pulmonary Chest Pain

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

JANUARY 27, 2024

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?

Chest Pain

Chest Pain STEMI Aneurysm Stents

Two patients with chest pain and RBBB: do either have occlusion MI?

Dr. Smith's ECG Blog

OCTOBER 17, 2024

Written by Jesse McLaren Two patients in their 70s presented to the ED with chest pain and RBBB. Patient 1 : a 75 year old called paramedics with one day of left shoulder pain which migrated to the central chest, which was worse with deep breaths. Ten days later the patient returned with worsening pleuritic chest.

Chest Pain

Chest Pain STEMI Pulmonary Embolism

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Acute Dyspnea and Right Bundle Branch Block

Dr. Smith's ECG Blog

NOVEMBER 17, 2023

Ken (below) is appropriately worried about pulmonary embolism from the ECG. What I had not told him before he made that judgement is that the patient also had ultrasound B-lines of pulmonary edema. LV aneurysm has QS-waves, so this couldn't be LV aneurysm, right? Finally, the presentation is dyspnea, not chest pain.

Aneurysm

Aneurysm Stents Stent Chest Pain

Pulmonary Edema, Hypertension, and ST Elevation 2 Days After Stenting for Inferior STEMI

Dr. Smith's ECG Blog

APRIL 12, 2013

He had no chest pain. He was in acute distress from pulmonary edema, with a BP of 180/110, pulse 110. He had diffuse crackles on exam and B-lines on chest ultrasound, and chest x-ray also confirmed pulmonary edema. The hypertension alone is the likely etiology of the pulmonary edema.

STEMI

STEMI Pulmonary Stents Stent

Case Report: Endoluminal removal of a conical retrievable superior vena cava filter with a retraction hook attached to the wall

Frontiers in Cardiovascular Medicine

JULY 2, 2024

Preoperative ultrasonography and CT examination revealed that the filter retraction hook was very likely to penetrate the SVC wall and its tip was very close to the right pulmonary artery. During this procedure, the patient experienced discomfort, such as chest pain and palpitations, but these symptoms disappeared when procedure completed.

Chest Pain

Chest Pain Pulmonary Aneurysm

A Patient with Respiratory Failure and a Computer "Normal" ECG

Dr. Smith's ECG Blog

MARCH 11, 2019

The only time you see this without ischemia is when there is an abnormal QRS, such as LVH, LBBB, LV aneurysm (old MI with persistent STE) or WPW." At some point he returned with chest pain, and all these findings were put into place. Many MI do not have chest pain 4. He was discharged and returned again.

Chest Pain

Chest Pain Ischemia Aneurysm Myocardial Infarction

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

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?

Chest Pain

Chest Pain Aneurysm STEMI Thrombosis

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Dr. Smith's ECG Blog

JULY 18, 2014

A man in his 60's presented after 4 days of chest pain, with some increase of pain on the day of presentation. Exact pain history was difficult to ascertain. Additionally , these patients have a high incidence of LV aneurysm with mural thrombus. There was some SOB. He had walked into the ED (did not use EMS).

STEMI

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

APRIL 8, 2015

Look for Vascular Etiology -- think of these while doing H and P: --Bleeding: ruptured AAA, GI bleed, ruptured ectopic pregnancy, other spontaneous bleed such as mesenteric aneurysms. Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. CONCLUSIONS: Many tests for syncope have a low diagnostic yield.

Arrhythmia

Arrhythmia Outcomes Chest Pain Risk Factors

Pulmonary edema, with tachycardia and OMI on the ECG -- what is going on?

Dr. Smith's ECG Blog

MARCH 3, 2025

A 69 year old woman with a history of hypertension presented to the emergency department by EMS for evaluation of chest pain and shortness of breath. She awoke in the morning with sharp chest pain which worsened throughout the morning. As her pain worsened, so did her dyspnea. This was written by Hans Helseth.

Tachycardia

Tachycardia Pulmonary Chest Pain Stenosis

Chest pain followed by 6 days of increasing dyspnea -- what happened?

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

Scenario 1 : The patient presents with 24 hours of substernal chest pain. When there are QS-waves, one should always think about LV aneurysm, but ST to QRS ratio and T-wave to QRS ratio are far too large and not compatible with left ventricular aneurysm. He presented to the emergency department for evaluation.

Chest Pain

Chest Pain Pericarditis Myocardial Infarction Dementia

Prehospital activation: De-activated on ED arrival by Cardiologist because "It's not a STEMI"

Dr. Smith's ECG Blog

OCTOBER 27, 2024

This was submitted by a paramedic, Hailey Kennedy A late 50s male called 911 following 2 hours of chest pain that started while working at his desk. He reported the crushing chest pain radiated down his left arm. He presented to the ED for evaluation chest pain. Pain was improved but not gone upon arrival.

STEMI

STEMI Chest Pain Myocardial Infarction Aneurysm

Case Report: Surgical management of idiopathic pulmonary aneurysms and review surgical approaches

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

Two patients with chest pain and RBBB: do either have occlusion MI?

Webinars

Acute Dyspnea and Right Bundle Branch Block

Pulmonary Edema, Hypertension, and ST Elevation 2 Days After Stenting for Inferior STEMI

Case Report: Endoluminal removal of a conical retrievable superior vena cava filter with a retraction hook attached to the wall

A Patient with Respiratory Failure and a Computer "Normal" ECG

A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Pulmonary edema, with tachycardia and OMI on the ECG -- what is going on?

Chest pain followed by 6 days of increasing dyspnea -- what happened?

Prehospital activation: De-activated on ED arrival by Cardiologist because "It's not a STEMI"

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