Chest Pain Critical Care STEMI 
Dr. Smith's ECG Blog
SEPTEMBER 3, 2023
This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.
Dr. Smith's ECG Blog
JULY 23, 2024
I was working at triage when the medics brought this patient who is 65 yo and has had chest pain for 12 hours. I took the patient to the critical care area and questioned him more on the way. The pain had been intermittent until an hour before arrival, when he called 911. So I uncrumpled it: What do you think?
Dr. Smith's ECG Blog
NOVEMBER 1, 2022
This EKG was recorded as part of a standing order for critical care. Upon questioning patient, he denies having any chest pain or chest tightness of any sort. In the absence of chest pain and negative troponin , it appears less likely that he is having acute coronary syndrome though EKG appears concerning.
Dr. Smith's ECG Blog
SEPTEMBER 7, 2024
He reports significant chest pain at the base of his scapula on the right side along with new shortness of breath. Smith : there is some minimal ST elevation in V2-V6, but does not meet STEMI criteria. Transient STEMI has been studied and many of these patients will re-occlude in the middle of the night. Is it normal STE?
Dr. Smith's ECG Blog
MARCH 6, 2023
If you saw this ECG only knowing that it is an acute chest pain patient, what would be your interpretation? There was high suspicion of OMI, so patient was brought to critical care area and another ECG was recorded just 7 minutes later as the pain had diminished to 4/10. Suspicious but not diagnostic.
Dr. Smith's ECG Blog
OCTOBER 26, 2010
This 54 year old patient with a history of kidney transplant with poor transplant function had been vomiting all day when at 10 PM he developed severe substernal crushing chest pain. At first glance, it seems the patient is having a STEMI. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock.
Dr. Smith's ECG Blog
SEPTEMBER 1, 2023
A 50-something male had onset of chest pain 1 hour prior to ED arrival. Endorses some associated SOB, but denies back pain, fever, cough, chills, leg swelling, or other new symptoms. It was tested on a large database of known outcomes and was more than twice as senstivity as STEMI criteria and much better than cardiologists.
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