Chest Pain Critical Care Stenosis 
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. The patient was moved to the critical care area (stabilization room). Always get serial ECGs in a patient with acute chest pain.
Dr. Smith's ECG Blog
JANUARY 15, 2024
Colin is an emergency medicine resident beginning his critical care fellowship in the summer with a strong interest in the role of ECG in critical care and OMI. They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. Edits by Willy Frick.
Dr. Smith's ECG Blog
APRIL 29, 2023
A 50-something with no previous cardiac history and no risk factors presented to the ED with acute chest pain (pressure) that radiated to the left arm. But even without these additional findings — the "Must Recognize" ECG pattern in this patient with new chest pain — is the unmistakeable shape of the ST depression in leads V2 and V3!
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. Wellen's waves indicate that, when the patient was having chest pain, there was occlusion. See these casese (and I have many others): First ED ECG is Wellens' (pain free). A 70-something y.o.
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. Left main: no significant stenosis.
Dr. Smith's ECG Blog
JULY 16, 2022
This middle aged male with h/o GERD but also h/o stents presented to the ED with chest pain. The initial troponin I returned at 1500 ng/L and another ECG was recorded as the patient complained of 9/10 chest pain at 10 hours after the first Now the T-wave in III is fully upright, suggesting re-occlusion.
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