Dr. Smith's ECG Blog

MAY 20, 2024

The Queen of Hearts disagrees, diagnosing OMI with high confidence: Case Continued: The EKG was not immediately recognized by the emergency provider, who ordered a CT scan to rule out aortic dissection at 1419. Smith comment 2: I frequently see failure to control BP in patients with acute chest pain or acute heart failure.

Chest Pain 126

Chest Pain Blood Pressure Ischemia STEMI 126

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Look at the aortic outflow tract. The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve. Aortic angiogram did not reveal aortic dissection. What do you see? Answer below in the still shot.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

EMS 12-Lead

MAY 20, 2022

There is ventricular hypertrophy in the absence of abnormal loading conditions, such as aortic stenosis, or hypertension, for example – of which the most common variant is Asymmetric Septal Hypertrophy. Type II MI), however decided to pursue coronary angiogram out of an abundance of caution.

Cardiomyopathy 52

Cardiomyopathy Ischemia STEMI Coronary Angiogram 52

BoardVitals - Cardiovascular

MAY 1, 2017

While the first one may radiate to the axilla and base, but usually not into the neck, it does reflect both aortic outflow obstruction and mitral regurgitation in patients with a large gradient. On the other hand, the murmur in valvular aortic stenosis does not change substantially or decreases slightly following the Valsalva maneuver.

Cardiomyopathy 52

Cardiomyopathy Sudden Cardiac Death Bicuspid/Mitral Electrocardiogram 52

Dr. Smith's ECG Blog

JANUARY 9, 2023

CT angiogram chest: no aortic dissection or pulmonary embolism. He was transitioned to oral heart failure medications and discharged home slightly over one week after presentation. He was readmitted a few weeks later for a heart failure exacerbation, diuresed, and discharged again.

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52

Dr. Smith's ECG Blog

MARCH 3, 2025

Anything that causes pulmonary edema: poor LV function, fluid overload, previous heart failure (HFrEF or HFpEF), valvular disease. Smith : "decompensation" of aortic stenosis might have initiated this entire cascade. What "initiates" the aortic stenosis cascade? What other pathology is possible?

Tachycardia 73

Tachycardia Pulmonary Chest Pain Stenosis 73