Bicuspid/Mitral Chest Pain Ischemia 
Dr. Smith's ECG Blog
APRIL 26, 2017
There was no chest pain or SOB at the tim of the ECG: Computerized QTc is 464 ms A previous ECG from 8 years prior was normal. Absence of chest pain or SOB at the time of the ECG is important; had the patient had active chest pain, I would have recommended at least an emergency formal echo, if not cath lab activation.
EMS 12-Lead
JULY 24, 2023
But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chest pain was a little more intense, and the needed recovery period was longer in duration. It should be known that each category can easily manifest the generic subendocardial ischemia pattern.
EMS 12-Lead
MAY 20, 2022
Additional architectural changes include systolic anterior motion of the mitral valve, endothelial dysfunction at the level of the coronary arterial bed, and ventricular diastolic dysfunction. There is broad subendocardial ischemia as demonstrated by STE aVR with concomitant STD that almost appears appropriately maximal in Leads II and V5.
Dr. Smith's ECG Blog
DECEMBER 18, 2022
Case A 39-year-old male without prior medical history presents with chest pain that started 2 hours prior to presentation. He says that the pain intensity was 10/10 at home but now about 4/10. Despite the clinical stability and decreasing pain, this patient needs an immediate angiogram. Here are his publications.)
Dr. Smith's ECG Blog
NOVEMBER 28, 2022
Given her reported chest pain, shortness of breath, and syncope, an ECG was quickly obtained: What do you think? However, if you freeze the ultrasound clip and scroll forwards and backwards to find a time during the clip where the patient’s mitral valve is open, you know the heart is filling, and is therefore in diastole.
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. There is no evidence of infarction or ischemia. Mild to moderate mitral regurgitation. BP:143/99, Pulse 109, Temp 37.2 °C C (99 °F), Resp (!)
Dr. Smith's ECG Blog
MARCH 3, 2025
A 69 year old woman with a history of hypertension presented to the emergency department by EMS for evaluation of chest pain and shortness of breath. She awoke in the morning with sharp chest pain which worsened throughout the morning. As her pain worsened, so did her dyspnea. This was written by Hans Helseth.
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