Remove Angina Remove Arrhythmia Remove Chest Pain
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46 year old with chest pain develops a wide complex rhythm -- see many examples

Dr. Smith's ECG Blog

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. The patient continued having chest pain. There are three mechanisms of arrhythmia: automatic, re-entry, and triggered.

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The Hidden Toll of Chronic Stress on Your Heart Health

MIBHS

Arrhythmias (Abnormal Heart Rhythms) Stress hormones can disrupt the signals that regulate your heartbeat, leading to arrhythmias – abnormal heart rhythms that cause your heart to beat too fast, too slow, or irregularly.

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Three normal high sensitivity troponins over 4 hours with a "normal ECG"

Dr. Smith's ECG Blog

They also documented "Reproducible chest tenderness." Remember, reproducible chest tenderness should not reassure you in patients with high pre-test probability of OMI. Thus, the patient does not (yet) get a formal diagnosis of MI and must be called unstable angina unless further troponins return above the 99th percentile.

Angina 115
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Sildenafils effectiveness in the primary coronary slow flow phenomenon: a pilot randomised controlled clinical trial

Open Heart

Background On the one hand, the primary coronary slow flow phenomenon (CSFP) can cause recurrence of chest pain, prompting medical examinations and further healthcare costs, while on the other hand, it can lead to myocardial infarction, ventricular arrhythmia and sudden cardiac death.

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Is this a STEMI? No, not by definition! Why not? Why is this Important?

Dr. Smith's ECG Blog

Therefore this is " Transient ST Elevation Unstable Angina." As there was ruptured plaque, this is NOT Prinzmetal's angina. Here are many other cases of Unstable Angina , in spite of Eugene Braunwald's Requiem for Unstable Angina. So Unstable Angina still exists [even with high sensitivity (hs) troponins].

STEMI 40
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Precordial ST depression. What is the diagnosis?

Dr. Smith's ECG Blog

A middle aged male with no h/o CAD presented with one week of crescendo exertional angina, and had chest pain at the time of the first ECG: Here is the patient's previous ECG: Here is the patient's presenting ED ECG: There is isolated ST depression in precordial leads, deeper in V2 - V4 than in V5 or V6. BP was 160/100.

STEMI 52
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ECG Blog #386 — OMI or Something Else?

Ken Grauer, MD

This should result in at least some positivity of QRS complexes as one moves toward the lateral chest leads. The finding of all negative QRS complexes in leads V3-thru- V6 therefore strongly suggests that the arrhythmia-associated impulse is not traveling over an AP ( Steurer et al — Clin. Cardiol 17:306-308, 1994 ).

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