Dr. Smith's ECG Blog

JANUARY 17, 2025

ECG Patterns of Occlusion Myocardial Infarction: A Narrative Review

Myocardial Infarction 52

Myocardial Infarction Article 52

Cassling

DECEMBER 14, 2023

Insights into technology and what the future holds for MRI, CT and more were among our most viewed articles by far. As we reviewed our most popular publications of 2023, it became clear that many of you continue to rethink the limits of your profession. We’ll continue to bring you these insights and many more in 2024.

Technology 98

Technology Innovation Ultrasound Article 98

Dr. Smith's ECG Blog

OCTOBER 8, 2024

HYPERACUTE T-WAVES ARE EASILY RECOGNIZED BY THE QUEEN OF HEARTS HYPERACUTE T-WAVES DO NOT EVOLVE INTO ST ELEVATION -- THIS IS A MYTH Pendell and I are about to submit an article on ECG findings in total 100% LAD Occlusion (LAD OMI). For more on Precordial Swirl — See the October 15, 2022 post in Dr. Smith's ECG Blog ).

Cardiac Arrest 122

Cardiac Arrest Myocardial Infarction STEMI Cardiogenic Shock 122

Dr. Smith's ECG Blog

AUGUST 2, 2024

Readers of this blog can easily appreciate the hyperacute T waves in the precordium, clearest in V1-V4. We've highlighted a considerable number of acute RV MI cases in Dr. Smith's ECG Blog ( See the October 7, 2019 and May 10, 2024 posts , to name just two ). His ECG is shown below. Pretty obvious anterior current of injury.

STEMI 119

STEMI Ischemia Blog Chest Pain 119

Dr. Smith's ECG Blog

JUNE 11, 2024

Many systems now refrain from showing computer "normal" ECGs to the busy emergency physicians at triage because of very poorly conceived articles that say that if the computer algorithm says "normal," the emergency physician should not be bothered. We have shown many examples of this on this blog. No further follow up is available.

Chest Pain 113

Chest Pain STEMI Blog Exercise 113

Dr. Smith's ECG Blog

OCTOBER 6, 2024

I described "Posterior Reperfusion T-waves" in this article. For more on ECG findings in pulmonary disease — Check out My Comment in the May 31, 2024 post in Dr. Smith's ECG Blog ). As often emphasized in Dr. Smith's ECG Blog — there is normally slight, upward sloping ST elevation in leads V2 and V3.

Hospital 77

Hospital Chest Pain Blog Pulmonary 77

Dr. Smith's ECG Blog

DECEMBER 13, 2024

NOTE: The ECGs in today's case are recorded in the Cabrera Format ( See Dr. Grauer Comment in the October 26, 2020 post of Dr. Smith's ECG Blog for review on the Cabrera Format ). How would you manage this patient? Figure-1: The initial ECG in today's case. ( To improve visualization I've digitized the original ECG using PMcardio ).

AFIB 103

AFIB Atrial Fibrillation Tachycardia Blog 103

Dr. Smith's ECG Blog

JANUARY 9, 2024

As I have discussed the user-friendly and time-efficient criteria I favor for distinction between VT vs SVT rhythms ( with either preexisting BBB or aberrant conduction ) — I'll refer those interested in more detail to My Comments in the May 5, 2020 — the April 2, 2022 — and the February 14, 2022 posts in Dr. Smith's Blog.

Tachycardia 119

Tachycardia Electrophysiology Atrial Flutter Ischemia 119

Cassling

DECEMBER 30, 2024

When we reviewed our top articles of the year, it became clear that what resonated more than anything else were in-depth looks at technology, the cost of that technology, and the myriad other innovations changing the clinical conversation. Here are the top articles of 2024. 2024 was a year of innovation across the imaging spectrum.

Article 52

Article Innovation Technology Blog 52

Dr. Smith's ECG Blog

JANUARY 6, 2024

Today's case is unique in that: i ) I believe it to be the 1st time we are publishing an example of this less commonly encountered form of lead reversal in Dr. Smith's ECG Blog; and , ii ) Because the patient's underlying baseline ECG abnormalities made recognition of this form of lead reversal that much more difficult to identify.

Blog 111

Blog Ischemia Tachycardia Physiology 111

Cassling

DECEMBER 22, 2022

In 2022, a few key trends stuck out when reviewing Cassling's most popular articles. In this recap, check out the Top 10 articles of the year to discover what had the imaging world abuzz in 2022. The latest technology advances were top of mind, as was patient experience, staffing, and more.

Article 52

Article Technology Blog 52

Dr. Smith's ECG Blog

JULY 14, 2023

Non-randomized trials show better outcomes (neurologic survival) using this device; see this article in Resuscitation: Head and Thorax Elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival. The patient had ROSC and maintained it. First — Some thoughts on the post -resuscitation ECG.

Cardiac Arrest 98

Cardiac Arrest Chest Pain Defibrillator Atrial Flutter 98

Dr. Smith's ECG Blog

MARCH 14, 2024

This is obviously unreliable data, as Dr. Smith’s Blog has published 51 cases of OMI with ECGs labeled ‘normal’ , 35 of which were identified by the Queen of Hearts – with 10 examples here. For all cases, see the supplement from the online version of the article. It should never have been published.

Chest Pain 119

Chest Pain STEMI Outcomes Electrocardiogram 119

Dr. Smith's ECG Blog

MAY 13, 2020

I have posted previous such cases, but in searching my own blog, I could not find them. Dr. Smith also referenced an article by Knotts et al, showing that even when diffuse subendocardial ischemia is due to coronary disease — that only a minority of patients had severe LMain coronary disease as the cause.

Echocardiogram 52

Echocardiogram Ischemia Chest Pain Blog 52

Conquering CHD

NOVEMBER 29, 2023

From webinars to informative articles, they are committed to spreading awareness and understanding. This committee will continue to be the driving force behind our efforts to influence public policy, raise awareness, and ensure that the CHD community’s voice is heard.

Webinar 98

Webinar Pediatrics Congenital Research 98

Dr. Smith's ECG Blog

MARCH 27, 2025

Smith : we have an article under review that shows that the variable most closely associated with the final diagnosis of "STEMI" vs. "Non-STEMI" was a door to balloon time less than, vs. greater than, 90 minutes. But because of the delayed reperfusion, the discharge was Non-STEMI.

STEMI 80

STEMI Chest Pain Pericarditis Ischemia 80

Dr. Smith's ECG Blog

NOVEMBER 8, 2022

NOTE: I reproduce in the ADDENDUM below ( in Figures-3 , - 4 and - 5 ) — the 3-page article by Rowlands and Moore ( J. As we have pointed out on multiple occasions ( See My Comment at the bottom of the page in the April 17, 2022 post in Dr. Smith's ECG Blog ) — lead V1,V2 malposition is surprisingly common in practice.

Article 52

Article Chest Pain Blog Myocardial Infarction 52

Dr. Smith's ECG Blog

JUNE 14, 2017

He has a great blog too: ECG Interpretation He is also well known on the Facebook EKG Club page , where you can learn tons about ECGs: Here is his response, with the first ECG labelled: Hello Steve & Avinash. It is commonly seen in the reperfusion setting. It appears to be benign in children as well (see references below).

Chest Pain 52

Chest Pain Congenital Heart Disease Article Congenital 52

Dr. Smith's ECG Blog

SEPTEMBER 26, 2023

See these 2 articles Association between pre-hospital chest pain severity and myocardial injury in ST elevation myocardial infarction: A post-hoc analysis of the AVOID study Author links open overlay panel [link] 1 Background We sought to determine if an association exists between prehospital chest pain severity and markers of myocardial injury.

Chest Pain 119

Chest Pain STEMI Myocardial Infarction Electrocardiogram 119

Dr. Malcolm Kendrick

AUGUST 26, 2022

26th August 2022 And so, after a great deal of faffing about, my article on cardiovascular disease ‘Assessing cardiovascular disease: looking beyond cholesterol’ has been made free to view. Writing an article for a medical journal is not that difficult. As for allowing the article to be open access … don’t go there.

Cardiovascular Disease 40

Cardiovascular Disease Cholesterol Article Plaque 40

Dr. Smith's ECG Blog

JANUARY 27, 2024

Interpretation by the GE/Marquette 12 SL conventional algorithm Smith : This article, published this month (!) , tells us that we physicians do not need to even look at this ECG until the patient is placed in a room because the computer says it is normal: Validity of Computer-interpreted “Normal” and “Otherwise Normal” ECG in Emergency Department Triage (..)

Chest Pain 117

Chest Pain STEMI Aneurysm Stent 117

Society of Thoracic Surgeons - Technology

MARCH 2, 2022

Blog Introducing New Technology to an Institution jbagley Wed, 03/02/2022 - 11:15 Innovation and new technology are essential to the progress of any specialty. This article will discuss how to introduce new technology to an institution. Van Haren, MD, MsPH Career Development Blog Early Career Technology March 2, 2022 Robert M.

Technology 52

Technology Blog Cardiothoracic Outcomes 52

Dr. Smith's ECG Blog

APRIL 25, 2023

We've previously discussed the all-too-often ignored entity known as MINOCA ( = MI with N on- O bstructive C oronary A rteries ) — which we detailed in the November 30, 2022 post in Dr. Smith's ECG Blog ( See My Comment at the bottom of the page ). Don't assume that young people don't have OMI!!

Chest Pain 52

Chest Pain Pericarditis Blog Cardiomyopathy 52

Dr. Smith's ECG Blog

NOVEMBER 5, 2023

As I illustrated in detail in My Comment of the October 3, 2018 post of Dr. Smith's ECG Blog — I favor a qualitative approach based on shape.

Chest Pain 111

Chest Pain Pacemaker Ischemia Stent 111

Dr. Smith's ECG Blog

SEPTEMBER 27, 2019

These were read by our fantastic chief of radiology, Gopal Punjabi, who has his own blog on Spectral CT: [link] [link] Here is the image using Spectral CT : It is much more obvious with this technique! A slice at a slightly different level: Again, an area with absence of contrast enhancement (dark-, not light-colored).

Chest Pain 52

Chest Pain Blog Ischemia Article 52

Dr. Smith's ECG Blog

DECEMBER 5, 2022

Arterial pulse tapping artifact [link] This online article references the article below by Emre Aslanger, a great guy who occasionally corresponds with me about ECGs. NOTE: I reproduce below ( in Figures-3 , - 4 and - 5 ) — the 3-page article by Rowlands and Moore ( J. Aslanger E, Yalin K.

Article 52

Article Chest Pain Circulation Electrocardiogram 52

Dr. Smith's ECG Blog

JANUARY 30, 2018

Ryan Burch, RN, was the nurse caring for the patient, later sent me the same ECG, stating the following: "This ECG had people stumped and concerned but I read an article in www.ecgmedicaltraining.com (see below) about an artifact a few weeks prior which I thought looked similar and the suggestion was that a lead had been placed over an artery.

Article 52

Article Nursing RN Circulation 52

BoardVitals - Cardiovascular

MAY 8, 2016

Therefore reading recent nuclear cardiology articles in journals accessible to you may be helpful. The post How to Effectively Prepare for the Nuclear Cardiology Boards appeared first on BoardVitals Blog. Recently in nuclear cardiology there has been a shift to emphasis on new hardware (i.e. solid state detectors), new software (i.e.

Certification 52

Certification Blog Article 52

Dr. Smith's ECG Blog

MAY 8, 2014

Articles on TCA More TCA ECGs from Dr. Smith's ECG Blog More on TCA overdose, with ECGs, from life in the fast lane. His delirium greatly improved and he was then able to follow commands. He had a prolonged stay in the ICU requiring days of bicarbonate. The tox screen only showed amitryptiline.

Tachycardia 52

Tachycardia Dysrhythmia ICU Pharmacology 52

Cassling

SEPTEMBER 8, 2023

This article was originally published on AuntMinnie.com on August 21, 2023. Click here to view the original article. With all these variables on the table, it's no surprise that radiology technologists want tools at their disposal that will help them be efficient, effective, and at the forefront of the field.

Radiologic Technologist 52

Radiologic Technologist Technology Soft Skills Article 52

Dr. Smith's ECG Blog

DECEMBER 20, 2013

For myself (and I suspect other readers of this blog), however, it affected my perception in exactly the opposite way – it immediately made me suspicious of misdiagnosis and wary of the dangers of diagnosing pericarditis (and therefore missing other diagnoses). There does not seem to be good evidence to answer this question, unfortunately.

Pericarditis 52

Pericarditis Chest Pain Pulmonary STEMI 52

Dr. Smith's ECG Blog

FEBRUARY 15, 2018

Normal QRS-T angle From this article: Ziegler R and Bloomfield DK. Yes, there are valuable articles from 50 years ago! A study of the normal QRS-T angle in the frontal plane. Journal of Electrocardiology 3(2):161-167; 1970.

Chest Pain 52

Chest Pain Critical Care Article Pacemaker 52

CineECG

JULY 11, 2023

data derived from Kashou et al article ECG interpretation proficiency of healthcare professionals In the previous study the difference in performance of ECG interpretation was mainly focused at cardiologists versus non cardiologist. The post ECG interpretation should and can improve appeared first on ECG-Excellence.

Nursing 52

Nursing Allied Health Blog Anatomy 52

Dr. Smith's ECG Blog

JANUARY 17, 2023

In the December 5, 2022 post of Dr. Smith's ECG Blog — We show 4 additional cases of this pulse-tap artifact. The September 27, 2019 post — for the Rowlands & Moore article with the above-noted formulas for recognizing the “culprit” extremity. This is no longer the case! Why are the smallest artifactual deflections GREEN ?

Chest Pain 52

Chest Pain Physiology Blog Electrophysiology 52

Dr. Smith's ECG Blog

NOVEMBER 17, 2014

See this full text link to an article from JAMA on PCI in patients who present at 12 to 48 hours. Here is a link to a blog post with the formula , which we have recently validated and will publish. There is no question that this benefits from immediate PCI. As for thrombolytics, that is a bit riskier.

Aneurysm 52

Aneurysm STEMI Chest Pain Risk Factors 52

Dr. Smith's ECG Blog

MARCH 4, 2023

In the Marchik article, (assuming they defined it the same way, and the methods do not specify this), among patients with suspicion for PE, S1Q3T3 was found in 8.5% Finally , they found that S1Q3T3, precordial T-wave inversions V1-V4, and tachycardia were independent predictors of PE. What is an S1Q3T3? Very few studies define S1Q3T3.

Chest Pain 52

Chest Pain Embolism Tachycardia Pulmonary 52

Cardiometabolic Health Congress

JULY 12, 2023

A vast collection of webinars, CME activities, expert interviews, on-demand event recordings, news articles, drug pipelines, and many other resources are now grouped into areas of specialty focus.

Education 40

Education Webinar CME Pediatrics 40