Blood Pressure Bradycardia Chest Pain 
Dr. Smith's ECG Blog
SEPTEMBER 11, 2024
No Chest Pain, but somnolent. The fact that this is syncope makes give it a far lower pretest probability than chest pain, but it was really more than syncope, as the patient actually underwent CPR and had hypotension on arrival of EMS. Here is the ED ECG (a photo of the paper printout) What do you think?
Dr. Smith's ECG Blog
JUNE 19, 2024
Case An 82 year old man with a history of hypertension presented to the ED with chest pain at 1211. He described his chest pain as pleuritic and reported that it started the day prior while swinging a golf club. Another blood pressure was checked. In lead I, about 1.5 mm of ST elevation has developed.
Dr. Smith's ECG Blog
MAY 30, 2023
A 50-something man presented in shock with severe chest pain. BP was 108 systolic (if a cuff pressure can be trusted) but appeared to be maintaining BP only by very high systemic vascular resistance. Here is his ED ECG: There is bradycardia with a junctional escape. The patient was in clinical shock with a lactate of 8.
Dr. Smith's ECG Blog
OCTOBER 20, 2024
He woke up alert and with chest pain which he also had experienced intermittently over the previous few days. The history in today's case with sudden loss of consciousness followed by chest pain is very suggestive of ACS and type I ischemia as the cause of the ECG changes. What do you think? PUSH THE LYTICS !
Dr. Smith's ECG Blog
JULY 21, 2024
The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. An Impella device was placed to maintain cardiac output and perfusion pressures.
Dr. Smith's ECG Blog
MAY 5, 2022
He denied any chest pain or shortness of breath and stated he felt at his baseline yesterday prior to drug use. On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s. They recommended repeating his ECG and awaiting troponin since the patient did not have any chest pain.
Dr. Smith's ECG Blog
JANUARY 5, 2024
Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." The ECG shows sinus bradycardia but is otherwise normal. The patient said his chest pain was 4/10, down from 8/10 on presentation. The following ECG was obtained.
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