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Acute chest pain and ST Elevation. CT done to look for aortic dissection.

Dr. Smith's ECG Blog

Written by Willy Frick A 67 year old man with a history of hypertension presented with three days of chest pain radiating to his back. Due to the chest pain radiating into the patient's back, the ER physician ordered CTA chest to rule out aortic dissection. He had associated nausea, vomiting, and dyspnea.

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Young man with chest pain and an abnormal echocardiogram

Heart BMJ

Clinical introduction A man in his 40s with a history of hyperlipidaemia presented with intermittent, dull left-sided chest pain for 2 weeks that was not consistently exertional. Physical examination, an ECG, basic laboratories and a chest X-ray were unremarkable. A transthoracic echocardiogram was performed ( figure 1 ).

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A man in his 40s with 3 days of stuttering chest pain

Dr. Smith's ECG Blog

Written by Willy Frick A man in his early 40s with BMI 36, hypertension, and a 30 pack-year smoking history presented with three days of chest pain. He described it as a mild intensity, nagging pain on the right side of his chest with nausea and dyspnea. It started while he was at rest after finishing a workout.

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Unexpected finding on imaging: an aortic valve mass

Heart BMJ

After 24 hours, the patient was readmitted to the hospital with chest pain and troponin elevation, without ECG changes. A transthoracic echocardiogram (TTE) revealed a mobile mass on the right coronary cusp of the aortic valve ( figure 1 , ). Figure 1 A mobile mass (1.88

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Abnormal echocardiographic finding mimicking paracardiac cystic lesion

Heart BMJ

Previous medical interventions included a spectrum of procedures, including catheter-directed thrombectomy for popliteal artery aneurysms with thrombosis, vascular bypass grafting for cerebral-anterior communicating artery aneurysms and arch replacement and stent implantation for aortic dissecting aneurysms.

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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. They also wanted an aortic CT which was negative. Wellen's waves indicate that, when the patient was having chest pain, there was occlusion. What do you think the prehospital ECG showed (with pain)?

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"Pericarditis" strikes again

Dr. Smith's ECG Blog

Written by Pendell Meyers A man in his late 40s with several ACS risk factors presented with a chief complaint of chest pain. Several hours prior to presentation, while driving his truck, he started experiencing new central chest pain, without radiation, aggravating/alleviating factors, or other associated symptoms.