Dr. Smith's ECG Blog

NOVEMBER 11, 2023

Later, I found old ECGs: 5 month prior in clinic: V5 and V6 look like OMI 9 months prior in clinic with no chest symptoms: V5 and V6 look like OMI 1 year prior in the ED with chest pain: V5 and V6 sure look like a STEMI For this ECG and chest pain in the ED, the Cath lab activated. But the angiogram was clean.

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Stroke Strokes Chest Pain Cardiomyopathy 70

Wellnest

DECEMBER 31, 2023

Yes, COVID-19 symptoms can resemble a heart attack, including chest pain, shortness of breath, and changes in echocardiogram or EKG. Myocarditis symptoms can also mimic a heart attack, and small blood clots may cause pain. Can COVID-19 symptoms mimic a heart attack?

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COVID-19 Heart Attack Heart attacks Exercise 52

Ken Grauer, MD

JANUARY 13, 2024

On the other hand — the ST elevation seen in lead V1 is perfectly consistent with LVH and LV "strain" ( ie, The shape of this ST-T wave in lead V1, in association with the deep S wave in this lead — is a mirror-image opposite picture of the typical expected appearance of LVH with "strain" in a lateral chest lead ).

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Blog Ischemia AFIB Hypertension 159

Dr. Smith's ECG Blog

JULY 11, 2024

No patient with chest pain should be sent home without troponin testing. An echocardiogram showed severely reduced global systolic function with an EF of 20-25% and an LV apical thrombus. An echocardiogram showed an EF of 20-25%. Three months later, he had a follow up appointment for a reassessment of his LV function.

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Outcomes Stenosis Outpatient Echocardiogram 112

Dr. Smith's ECG Blog

JULY 16, 2022

This middle aged male with h/o GERD but also h/o stents presented to the ED with chest pain. The initial troponin I returned at 1500 ng/L and another ECG was recorded as the patient complained of 9/10 chest pain at 10 hours after the first Now the T-wave in III is fully upright, suggesting re-occlusion.

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Dr. Smith's ECG Blog

JANUARY 1, 2013

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. There is no ST elevation.

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STEMI Ischemia Chest Pain Myocardial Infarction 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

The pneumothorax was expanded with a chest tube At 17 hours, another ECG was recorded: It is now much less dramatic and has the morphology of Type 2 Brugada The hs troponin I peaked at 6500 ng/L -- this strongly suggests myocardial contusion. An echocardiogram was done. He has a family history concerning for arrhythmia.

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Arrhythmia Blog Chest Pain Cardiac Arrest 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chest pain to Dr. McLaren. See this case: what do you think the echocardiogram shows in this case?

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Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

OCTOBER 25, 2022

She reports that she is now unable to vagal out of her palpitations and is having shortness of breath and dull chest pain. She had an echocardiogram which was normal. Patients should be offered a choice for a trial of medication vs ablation for this non-life-threatening arrhythmia. Her initial EKG is below.

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Tachycardia Atrial Flutter Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

APRIL 15, 2020

Echocardiogram: Estimated left ventricular ejection fraction, lower limits of normal; 45-50%. There are 6 KEY parameters to consider in systematic assessment of any arrhythmia. Tele Monitor: Normal sinus rhythm throughout, no ectopic atrial or ventricular beats. Regional wall motion abnormality-inferior/inferoseptum: akinetic.

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Tachycardia Nursing Heart Disease Dysrhythmia 52

Dr. Smith's ECG Blog

JUNE 23, 2024

Echocardiogram showed LVEF 66% with normal wall motion and normal diastolic function. He did not remember whether he had experienced any chest pain. Two subsequent troponins were down trending. Within a few days, the patient was extubated and was neurologically intact.

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Chest Pain Cardiac Arrest Sudden Cardiac Death Blog 118

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. A transthoracic echocardiogram showed an LV EF of less than 15%, critically severe aortic stenosis , severe LVH , and a small LV cavity.

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Dr. Smith's ECG Blog

JANUARY 15, 2024

They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. They described the chest pain as severe, crushing, and non-radiating. Altogether, this strongly suggests inferolateral OMI, particularly in a patient with acute chest pain.

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Chest Pain Blog Arrhythmia Critical Care 64

MIBHS

OCTOBER 31, 2024

Arrhythmias (Irregular Heartbeats) Persistent abnormal heart rhythms can disrupt the heart’s pumping efficiency, eventually causing it to enlarge to maintain blood flow. Chest X-Ray A chest X-ray is often the first imaging test conducted, as it can reveal whether the heart is enlarged and by how much.

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Open Heart

APRIL 20, 2022

Twenty-one (41%) had normal echocardiogram, 13 (25%) a hypokinetic non-dilated cardiomyopathy (HNDC) and 17 (33%) a dilated cardiomyopathy (DCM). Clinical contexts leading to diagnosis were SCD in 3 (6%), ventricular arrhythmias in 15 (29%), chest pain in 8 (15%), heart failure in 6 (12%) and familial screening in 20 (38%).

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Cardiomyopathy Chest Pain Sudden Cardiac Death Heart Failure 52

Dr. Smith's ECG Blog

JULY 22, 2023

He denied chest pain or shortness of breath. In the clinical context of weakness and fever, without chest pain or shortness of breath, the likelihood of Brugada pattern is obviously much higher. Formal echocardiogram showed normal EF, no wall motion abnormalities, no pericardial effusion. There was a 0.9%

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Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 91

Wellnest

DECEMBER 21, 2022

However, an echocardiogram is a different test, also conducted for heart activity. If you experience any symptoms, such as chest pain, dizziness, unusual tiredness or fatigue, shortness of breath, or irregular heartbeat, your doctor would want you to go for an ECG test to find out the underlying cause.

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Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

BoardVitals - Cardiovascular

MAY 1, 2017

He has never had any chest pain. Echocardiogram is indicated (Correct) C. Start aspirin and Plavix Correct answer: (B) (B) Echocardiogram is indicated. He has no known prior medical history and does not take any medications. He complains of occasional shortness of breath on walking more than 2 blocks.

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Cardiomyopathy Sudden Cardiac Death Bicuspid/Mitral Electrocardiogram 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

A formal echocardiogram was completed the next day and again showed a normal ejection fraction without any focal wall motion abnormalities to suggest CAD. It was from a patient with chest pain: Note the obvious Brugada pattern. Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias.

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Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

MARCH 6, 2020

This middle-aged man with no cardiac history but with significant history of methamphetamin and alcohol use presented with chest pain and SOB, worsening over days, with orthopnea. Later, he underwent a formal echocardiogram: Very severe left ventricular enlargement (LVED diameter 7.4 BP:143/99, Pulse 109, Temp 37.2 °C

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Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52

Dr. Anish Koka

FEBRUARY 20, 2023

He was concerned because he had chest pain after his first mRNA vaccine and was uncomfortable with the risks of a second mRNA dose. He subsequently describes having sharp chest pain over the next few weeks. The pain resolved a few weeks later. He emphatically denies any history of cardiopulmonary disease.

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Dr. Smith's ECG Blog

APRIL 8, 2015

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). The most recent and probably best study is this: Canadian Syncope Arrhythmia Risk Score.

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Dr. Smith's ECG Blog

JANUARY 5, 2025

Written by Willy Frick A man in his 60s with hypertension and prior stroke presented with three days of crushing chest pain. He reported intermittent chest pain for the last few months, but never lasting this long. The cardiology consultant notes that pain is "almost resolved." There is active infarction.

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