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ECG Cases 49 – ECG and POCUS for Dyspnea and Chest Pain

ECG Cases

In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. The post ECG Cases 49 – ECG and POCUS for Dyspnea and Chest Pain appeared first on Emergency Medicine Cases.

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Which patient has the more severe chest pain?

Dr. Smith's ECG Blog

2 middle aged males presented with chest pain. Which had the more severe chest pain at the time of the ECG? Patient 2 at the bottom with a very subtle OMI complained of 10/10 chest pain at the time the ECG was recorded. 414 patients were included in the analysis.

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A 50-something with chest pain.

Dr. Smith's ECG Blog

This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.

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A 60-year-old diabetic with chest pain, cath lab activated

Dr. Smith's ECG Blog

Of course he said: "Yes, it was a 60 year old diabetic with Chest pain." More cases can be found on the blog here. As per Dr. Smith — I review in detail the mathematical relationships seen when there is APTA in one of the extremities in My Comment in the January 17, 2023 post of Dr. Smith's ECG Blog. That is not a STEMI.

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A 30-something with acute chest pain

Dr. Smith's ECG Blog

I assumed it was a patient with acute chest pain. It was a man in his 30s with chest pain. While statistical likelihood of acute OMI is clearly lower in younger adults — nothing is ruled out by age alone ( as per My Comment in the January 9, 2023 and December 5, 2023 posts in Dr. Smith's ECG Blog ). 27 post ).

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ECG Blog #392 — Repolarization T Waves?

Ken Grauer, MD

As discussed in many posts in this ECG Blog — despite not satisfying the millimeter-based definition of a STEMI — in this patient with new chest pain, the ECG findings in Figure-1 merit prompt cath lab activation without any need to wait for serum troponin to return elevated ( See ECG Blog #193 — regarding the new "OMI" paradigm ).

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Chest pain with serial ECGs – can you guess the sequence?

Dr. Smith's ECG Blog

Written by Jesse McLaren A 45-year-old presented with 24 hours of intermittent chest pain. On it’s own this is nonspecific, but in the right context this could be diagonal occlusion (if active chest pain) or infero-posterior reperfusion (if resolved chest pain). #2 Can you guess the sequence?