Dr. Smith's ECG Blog

JULY 14, 2023

Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation.

Cardiac Arrest 98

Cardiac Arrest Chest Pain Defibrillator Atrial Flutter 98

Dr. Smith's ECG Blog

APRIL 8, 2016

A late middle-aged man presented with one hour of chest pain. If cardiac arrest from hypokalemia is imminent (i.e., As I indicated above, in our cardiac arrest case, after pushing 40 mEq, the K only went up to 4.2 Most recent echo showed EF of 60%. He also had a history of chronic kidney disease, stage III.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Circulation

NOVEMBER 11, 2024

Case presentation:A 64-year-old man presented with one day of chest pain. Initial evaluation showed elevated cardiac enzymes (CE) and normal eosinophil count. TTE showed a reduced EF with multiple segmental abnormalities concerning for myocardial infarction. Electrocardiogram (EKG) was unremarkable.

Myocardial Infarction 40

Myocardial Infarction Coronary Angiogram Echocardiogram Chest Pain 40

Dr. Smith's ECG Blog

OCTOBER 9, 2018

The utility of the triage electrocardiogram for the detection of ST-segment elevation myocardial infarction. We record ECGs in triage on every patient with chest pain, and some other indications, and this amounts to 8000 ECGs in triage each year, costing at most $200,000 (8000 x $20.00). Am J Emerg Med 36(10):1771-1774.

Chest Pain 52

Chest Pain STEMI Cardiac Arrest Blog 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

No chest pain. His inpatient clinicians did not think that an urgent angiogram was warranted given that he was chest pain free, his EKG appeared nondiagnostic, and serial troponins were not elevating beyond 2 ug/L. Patients on dialysis often do not have chest pain in the setting of acute MI. Why is this?

Chest Pain 52

Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This patient, who is a mid 60s female with a history of hypertension, hyperlipidemia and GERD, called 911 because of chest pain. A mid 60s woman with history of hypertension, hyperlipidemia, and GERD called 911 for chest pain. It is also NOT the clinical scenario of takotsubo (a week of intermittent chest pain).

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

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. Written By Magnus Nossen — with edits by Ken Grauer and Smith. The below ECG was recorded.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

Other cases of LAD OMI with RBBB/LAFB: A man in his 40s who really needs you to understand his ECG Cardiac Arrest at the airport, with an easy but important ECG for everyone to recognize A woman in her 60s with 6 hours of chest pain, dyspnea, tachycardia, and hypoxemia Ventricular Fibrillation, ROSC after perfusion restored by ECMO, then ECG.

Chest Pain 52

Chest Pain Cardiogenic Shock Tachycardia Ischemia 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. Thirty-six patients (36%) presented with cardiac arrest, and 78% (28/36) underwent emergent angiography.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 4, 2021

Both of these patterns together suggest Aslanger's pattern , recently published in J Electrocardiology: A new electrocardiographic pattern indicating inferior myocardial infarction. FYI : 52 ng/L is the threshold for "rule in" by European studies as it has a high positive predictive value in the setting of chest pain.

Ischemia 40

Ischemia Pulmonary STEMI Chest Pain 40

Dr. Smith's ECG Blog

JANUARY 28, 2012

A middle aged patient who was 3 weeks s/p STEMI came from cardiac rehab where he developed some chest pain, dyspnea and weakness on the treadmill. In the ED he had some continued chest pain and hypotension. In a report of 6 cases at our institution (Hennepin County Medical Center), 2 survived with cardiac surgery.

Chest Pain 40

Chest Pain STEMI Pericarditis Ultrasound 40

Dr. Smith's ECG Blog

OCTOBER 13, 2023

Here is the history: 62 yo male w 2d of intermittent chest pain, now constant. Here is a more detailed history: Presented to the emergency department with chest pain. Patient states that he began to develop substernal chest pain two days ago. ng/ml) The sender asked: "Would you activate the cath lab?"

Chest Pain 116

Chest Pain STEMI Cardiac Arrest Myocardial Infarction 116

Frontiers in Cardiovascular Medicine

DECEMBER 20, 2024

IntroductionCardiac arrest during pregnancy is receiving increasing attention. However, there are few reports on cardiac arrest in nonpregnant women caused by abnormal uterine bleeding (AUB). At the initial stage of admission, cardiac arrest occurred after the ECG demonstrated ST-segment elevation in leads II, III and a VF.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Coronary Angiogram Myocardial Infarction 52

Dr. Smith's ECG Blog

MARCH 23, 2025

Written by Pendell Meyers, sent by anonymous, with additions by Smith A man in his 40s had acute chest pain and called EMS. Pharmacological facilitation of primary percutaneous coronary intervention for acute myocardial infarction: is the slope of the curve the shape of the future? JAMA [Internet] 2005;293(8):97986.

STEMI 82

STEMI Chest Pain Myocardial Infarction Article 82