Remove Angioplasty Remove Chest Pain Remove Thrombolysis
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Chest pain, resolved. Does it need emergent cath lab activation (some controversy here)? And much much more.

Dr. Smith's ECG Blog

A 50-something male with hypertension and 20- to 40-year smoking history presented with 1 week of stuttering chest pain that is worse with exertion, which takes many minutes to resolve after resting and never occurs at rest. At times the pain does go to his left neck. It is a ssociated with mild dyspnea on exertion. Am Heart J.

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A woman in her 30s with sudden chest pain, nausea, and diaphoresis. Was her cardiology management appropriate?

Dr. Smith's ECG Blog

There is a patient with persistent chest pain and an initial troponin I over 52 ng/L; 52 ng/L has an approximate 70% PPV for acute type I MI in a chest pain patient. Pain was severe and persistent. CT angiography chest assessing for PE and dissection negative. Heparin drip was initiated. Is there STEMI?

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If you had recorded an ECG during chest pain, what would it have shown?

Dr. Smith's ECG Blog

He had suffered a couple bouts of typical chest pain in the last 24 hours. This ECG (ECG #3) was recorded immediately after the last episode of pain spontaneously resolved. The pain had lasted about one hour. Case A 40-something male presented to triage. There are classic Wellens' waves in V2-V5. Am Heart J.

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An elderly male with shortness of breath

Dr. Smith's ECG Blog

He reports significant chest pain at the base of his scapula on the right side along with new shortness of breath. Wellen's waves indicate that, when the patient was having chest pain, there was occlusion. See these casese (and I have many others): First ED ECG is Wellens' (pain free). A 70-something y.o.

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Right precordial ST depression in a patient with chest pain

Dr. Smith's ECG Blog

A 70-year-old man calls 911 after experiencing sudden, severe chest pain. New electrocardiographic criteria for posterior wall myocardial ischemia validated by percutaneous transluminal coronary angioplasty model of acute myocardial infarction. This case comes from Sam Ghali ( @EM_RESUS ). Thanks, Sam! Neth Heart J.

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ECG Blog #373 — 86yo and this Rhythm.

Ken Grauer, MD

No chest pain. Figure-1: The initial ECG in today's case — obtained from an 86-year old man with presyncope, but no chest pain. ( The 12-lead ECG and long lead II rhythm strip in Figure-1 was obtained from an 86-year old man — who presented to the ED ( E mergency D epartment ) with presyncope. What is the rhythm ?

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A Tough ECG, But Learn From It!

Dr. Smith's ECG Blog

This was my thought: if this patient presented to the ED with chest pain, then this is an LAD occlusion. Usefulness of automated serial 12-lead ECG monitoring during the initial emergency department evaluation of patients with chest pain. Ann Emerg Med 1998;31(1):3-11. Wang T, Zhang M, Fu Y, et al. Marti D et al.

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