Dr. Smith's ECG Blog

NOVEMBER 15, 2023

Post cath ECG: Now there are hyperacute T-waves again, and recurrent ST depression in V2 This ECG would normally diagnostic of OMI until proven otherwise No further troponins were measured, but it looks like there is recurrent OMI Next day: A CT Coronary Angiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. IMPRESSION: 1.

Coronary Angiogram 101

Coronary Angiogram Plaque Thrombosis STEMI 101

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Pads were placed with ultrasound guidance, so they were in the correct position. Cardiology was consulted and the patient underwent coronary angiogram which showed diffuse severe three-vessel disease. Coronary angiogram shows diffuse severe three-vessel disease. However, this is not SVT. Shocked x 2 without effect.

Tachycardia 136

Tachycardia Cardiogenic Shock Angina Coronary Angiogram 136

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. Edited by Smith He also sent me this great case. Assuming that was indeed a culprit, then this was ACS.

Chest Pain 122

Chest Pain Blood Pressure Ischemia STEMI 122

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

We investigated the incidence of an acutely occluded coronary in patients presenting with STE-aVR with multi-lead ST depression. All electrocardiograms (ECGs) and coronary angiograms were blindly analyzed by experienced cardiologists. A emergent cardiology consult can be helpful for equivocal cases. A normal PR interval.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 9, 2023

Beware a negative Bedside ultrasound. Young people can suffer acute coronary occlusion, whether by typical atherosclerotic plaque rupture, or by coronary anomalies, coronary aneurysms, dissections, spasm, etc. Chest Pain in a Male in his 20's; Inferior ST elevation: Inferior lead "early repol" diagnosed. Pericarditis?

Chest Pain 52

Chest Pain Aneurysm STEMI Thrombosis 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. Aortic angiogram did not reveal aortic dissection.

Ischemia 52

Ischemia Cardiogenic Shock Aortic Stenosis 52