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. A single DES stent was placed, and the patient did well post-procedure.

Chest Pain 52

Chest Pain Ischemia Myocardial Infarction ICU 52

Dr. Smith's ECG Blog

JULY 11, 2024

No patient with chest pain should be sent home without troponin testing. All three lesions had TIMI 2 flow prior to stenting. This is an RAO cranial projection of the left coronary vessels after thrombectomy and stenting. The LV aneurysm morphology persists. This is the RAO caudal projection.

Outcomes 94

Outcomes Stenosis Outpatient Echocardiogram 94

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. Old MI w/Aneurysm will show moderate ST Elevation, as seen here. Notice also that no lead has 1 mm of ST elevation.

Chest Pain 52

Chest Pain Aneurysm STEMI Hospital 52

Dr. Smith's ECG Blog

JANUARY 31, 2020

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

Angina Stents Stent Aneurysm 52

Dr. Smith's ECG Blog

FEBRUARY 29, 2016

He denied fevers and chills, abdominal pain, chest pain, or SOB. It was opened and stented. This may be permanent and may be associated with echocardiographic dyskinesis (aneurysm). LV aneurysm is common in completed, full thickness (transmural) MI, which is what we have here. The cath lab was activated.

Aneurysm 52

Aneurysm Ischemia Embolism STEMI 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

A middle-aged male with h/o CAD and stents presented with typical chest pressure. 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.

STEMI 52

STEMI Chest Pain Cardiac Arrest Stents 52

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.

Chest Pain 52

Chest Pain Blog Ischemia Article 52

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

MARCH 11, 2016

A middle-aged woman had intermittent angina for 48 hours, then onset of constant, crushing chest pain for 1.5 It was treated with and dual "kissing balloons" and drug eluting stents. Perhaps she will not develop an LV aneurysm. hours when she called 911. TIMI flow is 0. Door to balloon time was 51 minutes.

Myocardial Infarction 52

Myocardial Infarction Pericarditis Angina STEMI 52

Dr. Smith's ECG Blog

DECEMBER 18, 2022

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.)

Myocardial Infarction 52

Myocardial Infarction Chest Pain Blog Echocardiogram 52

Dr. Smith's ECG Blog

OCTOBER 26, 2011

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. An open 90% LAD was stented. Cath showed a 95% LAD with flow.

STEMI 52

STEMI Myocardial Infarction Chest Pain Angioplasty 52

Dr. Smith's ECG Blog

JANUARY 9, 2024

The patient is female in her 80s with a medical hx of previous MI with PCI and stent placement. She presented to the emergency department after a couple of days of chest discomfort. These are all findings that can be expected with left ventricular aneurysm. The last echocardiography 12 months ago showed HFmrEF.

Tachycardia 102

Tachycardia Electrophysiology Atrial Flutter Ischemia 102