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
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.
Dr. Smith's ECG Blog
OCTOBER 6, 2018
We knew only that the ECG belonged to a man in his 50s with chest pain and normal vitals. We brought the patient into one of our critical care rooms and immediately got more history while recording this repeat ECG: The STE in I has greatly diminished or entirely disappeared. No prior available. We activated the cath lab.
Dr. Smith's ECG Blog
FEBRUARY 12, 2023
There was no chest pain. Later, I was working in the ED and a patient was moved from a regular room to the critical care area due to recurrent hypotension. The patient was now under my care. But today's patient had no chest pain. That condition is tricuspid stenosis, which is rare.
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