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Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chestpain and nausea. The patient continued having chestpain. Circulation Research , 56 (2), 184–194. Do not treat AIVR. Is there STEMI?
Submitted and written by Megan Lieb, DO with edits by Bracey, Smith, Meyers, and Grauer A 50-ish year old man with ICD presented to the emergency department with substernal chestpain for 3 hours prior to arrival. At this time he reported ongoing chestpain and was given aspirin and nitroglycerin.
The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chestpain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. Written By Magnus Nossen — with edits by Ken Grauer and Smith. The below ECG was recorded.
ECG of pneumopericardium and probable myocardial contusion shows typical pericarditis Male in 30's, 2 days after Motor Vehicle Collsion, complains of ChestPain and Dyspnea Head On Motor Vehicle Collision. Gunshot wound to the chest with ST Elevation Would your radiologist make this diagnosis, or should you record an ECG in trauma?
Later, I found old ECGs: 5 month prior in clinic: V5 and V6 look like OMI 9 months prior in clinic with no chest symptoms: V5 and V6 look like OMI 1 year prior in the ED with chestpain: V5 and V6 sure look like a STEMI For this ECG and chestpain in the ED, the Cath lab activated. But the angiogram was clean.
Circulation, Volume 150, Issue Suppl_1 , Page A4140337-A4140337, November 12, 2024. The confirmation cohort, which was obtained from the National Institute of Health, consisted of 3315 patients with normal Bruce protocol treadmill stress test results in the Prospective Multicenter Imaging Study for Evaluation of ChestPain (PROMISE) Trial.
The rule of thumb is less accurate, and the risk is higher because a long QT in the presence of bradycardia ("pause dependent" Torsades) predisposes to Torsades. 6) Use a different rule of thumb for bradycardia : Manually approximate both the QT and the RR interval. 3) At heart rates below 60, far more caution is due.
This fantastic case and post was written by Jesse McLaren (@ECGcases), edited by Smith Case You’re shown an ECG from a patient in the waiting room with chestpain. Sinus bradycardia, normal conduction, normal axis, normal R wave progression, no hypertrophy. Circulation 2014 7. -- McLaren JTT, Meyers HP, Smith SW, Chartier LB.
60-something with h/o MI and stents presented with chestpain radiating to the back and nausea/vomiting. This is sinus bradycardia. M y I MPRESSION of E CG # 1 : In this patient with a history of documented coronary disease + new-onset chestpain — one has to assume new i nferior O MI until proven otherwise.
There was no chestpain. The physiologic reason for this — is thought to be the result of momentarily increased circulation from mechanical contraction arising from the "sandwiched in" QRS complex. This was written by Magnus Nossen The patient is a female in her 50s. She presented with a one week hx of «dizziness» and weakness.
A late middle-aged man presented with one hour of chestpain. There is also bradycardia. Bradycardia puts patients at risk for "pause-dependent" Torsades de Pointes. Torsades in acquired long QT is much more likely in bradycardia because the QT interval following a long pause is longer still. mEq/L, from 1.9
It was from a patient with chestpain: Note the obvious Brugada pattern. Circulation, 117, 1890–1893. [3]: The elevated troponin was attributed to either type 2 MI or to non-MI acute myocardial injury. There is no further workup at this time. Smith: Here is a case that was just texted to me today from a former resident.
She did notice something slightly wrong subjectively, but had no palpitations, chestpain, or SOB, or any other symptom. Baseline bradycardia in endurance athletes limits the use of ß-blockers. Ballatore et al — Medicina (Kaunas) 55(8): 497, 2019 — and — Page et al — Circulation 107:1141-1145, 2003 ).
Check : [vitals, SOB, ChestPain, Ultrasound] If the patient has Abdominal Pain, ChestPain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. Frequent or repetitive PACs ii.
days of chestpain that started as substernal and crushing in nature awakening him from sleep and occasionally traveling to right side of neck. The pain was described as constant, worse with deep inspiration and physical activity, sometimes sharp. Circulation. Erratum in: Circulation. He reported 1.5
Within ten minutes, she developed bradycardia, hypotension, and ST changes on monitor. Bradycardia and heart block are very common in RCA OMI. He had no chestpain, dyspnea, or any other anginal equivalent, and his vital signs were normal. Circulation Research , 114 (12), 18521866. Circulation , 92 (3), 657671.
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