Remove Chest Pain Remove Coronary Angiogram Remove Echocardiogram
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Syncope While Driving. Activate the Cath Lab?

Dr. Smith's ECG Blog

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. Case continued The patient underwent an emergency formal echocardiogram and it was unchanged. Learning Points: 1.

Aneurysm 115
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A man with chest pain off and on for two days, and "No STEMI" at triage.

Dr. Smith's ECG Blog

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.

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Abstract 4135360: Eosinophilic Myocarditis: An Atypical Presentation with a Labile Course: A Case Report

Circulation

Case presentation:A 64-year-old man presented with one day of chest pain. Transthoracic echocardiogram (TTE) showed an ejection fraction (EF) of 40% and a moderate-large pericardial effusion with signs of tamponade. A repeat coronary angiogram was unremarkable. Electrocardiogram (EKG) was unremarkable.

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See OMI vs. STEMI philosophy in action

Dr. Smith's ECG Blog

His medical history is unremarkable except a similar pain occurred 4-5 times in the previous 3 months with less intensity, short duration, unrelated to exertion. He visited an outpatient clinic for it and an echocardiogram and exercise stress test was normal. He has 40 packs-year of smoking history. He denies taking any medication.

STEMI 52
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Hypertropic Cardiomyopathy: A Board Review Question Explained By Video

BoardVitals - Cardiovascular

He has never had any chest pain. Echocardiogram is indicated (Correct) C. Start aspirin and Plavix Correct answer: (B) (B) Echocardiogram is indicated. 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.

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Critical Left Main

EMS 12-Lead

But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chest pain was a little more intense, and the needed recovery period was longer in duration. It’s judicious, then, to arrange for coronary angiogram. Coronary Angiogram 1.

Angina 52
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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

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. See this case: what do you think the echocardiogram shows in this case?