Chest Pain Defibrillator Stenosis 
Dr. Smith's ECG Blog
JANUARY 23, 2023
Submitted and written by Megan Lieb, DO with edits by Bracey, Smith, Meyers, and Grauer A 50-ish year old man with ICD presented to the emergency department with substernal chest pain for 3 hours prior to arrival. At this time he reported ongoing chest pain and was given aspirin and nitroglycerin.
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. She was defibrillated and resuscitated. Learning Points: 1.
Dr. Smith's ECG Blog
JUNE 27, 2024
A patient had a cardiac arrest with ventricular fibrillation and was successfully defibrillated. IF the initial ECG following successful defibrillation shows evidence of acute OMI — such patients have much to gain from immediate cath with PCI. The proof of this is that only 5% of patients enrolled had acute coronary occlusion.
Dr. Smith's ECG Blog
JANUARY 15, 2024
They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. They described the chest pain as severe, crushing, and non-radiating. Altogether, this strongly suggests inferolateral OMI, particularly in a patient with acute chest pain.
Dr. Smith's ECG Blog
JUNE 19, 2023
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.
Dr. Smith's ECG Blog
OCTOBER 20, 2024
He woke up alert and with chest pain which he also had experienced intermittently over the previous few days. The history in today's case with sudden loss of consciousness followed by chest pain is very suggestive of ACS and type I ischemia as the cause of the ECG changes. What do you think?
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. Angiography : LMCA — 90-99% osteal stenosis. The below ECG was recorded.
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