Dr. Smith's ECG Blog

JULY 11, 2024

No patient with chest pain should be sent home without troponin testing. The red arrow shows a roughly 80% stenosis of the proximal LAD. The blue arrow shows another stenosis of the LAD distal to the first diagonal branch of about 99%. The green arrow shows a 95% stenosis of the ostium of the first diagonal branch.

Outcomes 112

Outcomes Stenosis Outpatient Echocardiogram 112

Dr. Smith's ECG Blog

JANUARY 28, 2023

Case 1 A middle aged woman presented with acute chest pain and shortness of breath, unclear time since onset, and likely with episodic symptoms off and on throughout the day. Another lesion in the proximal LAD with 80% stenosis was stented as well. QS waves from V2-V5 consistent with LV aneurysm morphology.

STEMI 52

STEMI Chest Pain Stents Stent 52

Dr. Smith's ECG Blog

APRIL 17, 2023

The Queen of Hearts correctly says: Smith : Why is this ECG which manifests so much ST Elevation NOT a STEMI (even if it were a 60 year old with chest pain)? Here is the clinical informaton on ECG 2: A man in his 50s presented to the Emergency Department with acute chest pain that started within the past few hours.

Chest Pain 52

Chest Pain STEMI Document Ischemia 52

DAIC

SEPTEMBER 4, 2024

This can lead to complications such as blocked, reduced, or backward blood flow through the heart chambers, causing shortness of breath, chest pain, fainting, and difficulty exercising. In more severe cases, the disease can lead to an aortic dissection, or tear in the aorta, a life-threatening condition.

Aortic valve 52

Aortic valve Bicuspid/Mitral Aortic Research 52

Dr. Smith's ECG Blog

SEPTEMBER 20, 2018

Written by Pendell Meyers, edits by Steve Smith A man in his 60s with history of hypertension and MI 10 years ago, with PCI, presented to an outside hospital complaining of chest pain that started while mowing the lawn. TOP Initial ECG of this 60-year old man with a history of prior MI, who presented with new-onset chest pain.

Chest Pain 52

Chest Pain STEMI Cardiac Arrest Aneurysm 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

An elderly patient with a ruptured abdominal aortic aneurysm: Formal ECG Interpretation (final read in the chart!) : "Inferior ST elevation, lead III, with reciprocal ST depression in aVL." Case 3 : Male in 30's with chest pain, cough, and fever. What do you think? Does he need a stress test? --Is

STEMI 40

STEMI Chest Pain Cardiac Arrest Stents 40

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. heart auscultation (aortic stenosis); c. orthostatic vitals b.

Arrhythmia 52

Arrhythmia Outcomes Chest Pain Risk Factors 52

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 73

Tachycardia Pulmonary Chest Pain Stenosis 73

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 121

STEMI Chest Pain Myocardial Infarction Aneurysm 121