Dr. Smith's ECG Blog

JUNE 19, 2023

The patient’s chest pain spontaneously resolved before he was evaluated and has a repeat ECG obtained at 22:12 obtained shown below. In context, of course, it is clear that the patient is reperfusing, as pain has dissipated and the diagnostic findings of OMI have become more nonspecific. This ECG is more difficult.

Chest Pain 52

Chest Pain STEMI Cardiogenic Shock Ischemia 52

Dr. Smith's ECG Blog

MAY 24, 2022

A 30-something male presented in the middle of the night with several hours of sharp, non-radiating, left sided chest pain. CT coronary angiogram is excellent , but is rarely available outside of business hours, and hardly ever at night. He is a smoker and has some family history of early MI.

Chest Pain 52

Chest Pain Blog Coronary Angiogram Coronary Artery Disease 52

Dr. Smith's ECG Blog

JUNE 5, 2024

The patient presented due to chest pain that was typical in nature, retrosternal and radiating to the left arm and neck. He denied any exertional chest pain. It is unclear if the patient was pain free at this time. He has a medical hx notable for hypertension, hyperlipidemia and previous tobacco use disorder.

Chest Pain 101

Chest Pain Cardiac Arrest Blog Cardiomyopathy 101

Dr. Smith's ECG Blog

MAY 20, 2024

This was sent by an undergraduate (not yet in medical school, but applying now) who works as an ED technician (records all EKGs, helps with procedures, takes vital signs) and who reads this blog regularly. He called EMS, who arrived on scene about two hours after the onset of pain to find him hypertensive at 220 systolic.

Chest Pain 120

Chest Pain Blood Pressure Ischemia STEMI 120

Dr. Smith's ECG Blog

JULY 2, 2023

Chest pain or discomfort) What do you think? The total duration of chest pain was 30-45 minutes. Outcome The only followup we got was that the patient is undergoing Coronary Bypass (CABG) of LAD, 2nd Obtuse Marginal, and Left Posterolateral coronaries. But thanks to you, I feel much more confident.

Chest Pain 52

Chest Pain Angina Coronary Angiogram Stent 52

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

He had concurrent sharp substernal chest pain that resolved, but palpitations continued. Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest. Past medical history includes coronary stenting 17 years prior. Do you see proof that confirms VT?

Tachycardia 132

Tachycardia Cardiogenic Shock Angina Coronary Angiogram 132

Dr. Smith's ECG Blog

DECEMBER 9, 2023

The medics stated he had been nauseated and diaphoretic, but he did not have any chest pain or SOB. And especially suspect Old MI when the patient gives a history of MI and has no chest pain or SOB. He had a prehospital ECG. He was ambulatory at the scene. He has a history of STEMI and heart failure.

Aneurysm 102

Aneurysm Chest Pain Echocardiogram STEMI 102

Dr. Smith's ECG Blog

MAY 10, 2023

A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chest pain and SOB. She had one episode of pain the previous night and two additional episodes early on morning the morning she presented. Deep breaths are painful and symptoms come and go.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis Pulmonary 52

Dr. Smith's ECG Blog

MAY 16, 2023

Sent by Dan Singer MD, written by Meyers, edits by Smith A man in his late 30s presented with acute chest pain and normal vitals except tachycardia at about 115 bpm. Dr. Singer sent this to me with just the information: "~40 year old with acute chest pain". Anxiety is a common cause of chest pain with tachycardia.

Chest Pain 52

Chest Pain Pericarditis Tachycardia STEMI 52

Dr. Smith's ECG Blog

MAY 19, 2022

Written by Pendell Meyers, edits by Smith and Grauer A man in his late 20s with history of asthma presented to the ED with a transient episode of chest pain and shortness of breath after finishing a 4-mile run. Ct coronary angiogram showed normal coronary arteries. He typically runs 4 to 8 miles per day.

Chest Pain 52

Chest Pain Exercise Pacemaker Coronary Angiogram 52

Dr. Smith's ECG Blog

DECEMBER 22, 2022

Here is the coronary angiogram: A distal thrombotic right coronary artery (RCA) occlusion ! In a patient with ongoing, severe chest pain — the subtle-but-real ST-T wave changes are "dynamic" indication of an ongoing acute cardiac event — therefore prompting the need for cardiac cath!

STEMI 52

STEMI Chest Pain Myocardial Infarction Electrocardiogram 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. All electrocardiograms (ECGs) and coronary angiograms were blindly analyzed by experienced cardiologists.

Ischemia 52

Ischemia STEMI Stenosis Coronary Artery Disease 52

BoardVitals - Cardiovascular

MAY 1, 2017

He has never had any chest pain. The post Hypertropic Cardiomyopathy: A Board Review Question Explained By Video appeared first on BoardVitals Blog. 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. Start with a Free Trial.

Cardiomyopathy 52

Cardiomyopathy Sudden Cardiac Death Bicuspid/Mitral Electrocardiogram 52

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. The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve.

Ischemia 52

Ischemia Cardiogenic Shock Aortic Stenosis 52