Dr. Smith's ECG Blog

MAY 29, 2017

He had had several episodes of pain since onset; it was described as pressure-like and lasts about 5-15 minutes and resolves spontaneously. He had been pain free for about an hour. He had some "pre-diabetes ," but no h/o hypertension, no known family history of heart disease, and he smokes about 1-2 cigarettes per day.

Chest Pain 52

Chest Pain Ischemia Circulation Heart Disease 52

Frontiers in Cardiovascular Medicine

OCTOBER 8, 2024

ObjectiveAlthough the association between admission glucose (AG) and major adverse cardiac events (MACE) is well-documented, its relationship with 30-day MACE in patients presenting with cardiac chest pain remains unclarified. years, with 1,028 (60.29%) being male and 500 (29.33%) having diabetes. The median AG levels were 7.60 mmol/L

Chest Pain 52

Chest Pain Cardiogenic Shock Cardiac Arrest Myocardial Infarction 52

Dr. Smith's ECG Blog

JANUARY 15, 2024

A patient in their 40s with type 1 diabetes mellitus and hyperlipidemia presented to the emergency department with 5 days of “flu-like” illness. They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. They denied fever, cough, dyspnea, and sick contacts.

Chest Pain 64

Chest Pain Blog Arrhythmia Critical Care 64

Frontiers in Cardiovascular Medicine

JANUARY 14, 2024

Background The objective of this study was to investigate the differences in presenting symptoms between patients with and without diabetes being diagnosed with an acute myocardial infarction (AMI). Results Patients with diabetes had significantly less frequent typical pain symptoms, including typical chest pain.

Myocardial Infarction 64

Myocardial Infarction Diabetes Chest Pain Risk Factors 64

Dr. Smith's ECG Blog

NOVEMBER 26, 2015

52-year-old lady presents to the Emergency Department with 2 hours of chest pain, palpitations & SOB. Without them the diagnosis is often tough and one must often rely on other clinical data- serial ECG’s, troponin, on-going chest pain, etc. This is particularly true in women, diabetics, and the elderly.

Chest Pain 52

Chest Pain Aneurysm STEMI Document 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

Case submitted by Rachel Plate MD, written by Pendell Meyers A man in his 70s presented with chest pain which had started acutely at rest and has lasted for 2 hours. The pain was still ongoing at arrival. He had history of prior MIs and CABG, as well as diabetes, hypertension, and hyperlipidemia.

Chest Pain 52

Chest Pain Cardiac Arrest Cardiogenic Shock Heart Attack 52

Dr. Smith's ECG Blog

FEBRUARY 1, 2023

Written by Jesse McLaren, with edits from Smith A 30 year old with a history of diabetes presented with two days of intermittent chest pain and diaphoresis, which recurred two hours prior to presentation. The chest pain was refractory to nitro so the cath lab was activated: 100% proximal LAD and 99% mid circumflex occlusions.

Chest Pain 52

Chest Pain STEMI Ischemia Stenosis 52

Dr. Smith's ECG Blog

APRIL 9, 2023

Submitted by Ali Khan MD and James Mantas MD, MS, written by Pendell Meyers A man in his 50s with history of diabetes, hypertension, and tobacco use presented to the ED with 24 hours of worsening left sided chest pain radiating to the back, characterized as squeezing and pinching, associated with shortness of breath.

Chest Pain 52

Chest Pain Ischemia Stenosis Pulmonary 52

Dr. Smith's ECG Blog

MARCH 4, 2023

While I still had questions about this case given the limited information provided ( ie, Was chest pain in this younger adult diabetic from acute PE? Was the ECG ever repeated?

Chest Pain 52

Chest Pain Embolism Tachycardia Pulmonary 52

Dr. Smith's ECG Blog

AUGUST 19, 2023

Written by Jesse McLaren A 75 year-old patient with diabetes and end stage renal disease was sent to the ED after dialysis for three days of nausea, vomiting, loose stool, lightheadedness and fatigue. Because the patient had no chest pain or shortness of breath, they were initially diagnosed as gastroenteritis. Take home 1.

Chest Pain 98

Chest Pain STEMI Myocardial Infarction Blog 98

Dr. Smith's ECG Blog

MAY 8, 2023

Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. Sent by Pete McKenna M.D. Triage ECG: What do you think? This is diagnostic of proximal LAD occlusion. I cannot be anything else.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Pacemaker 52

Dr. Prateek Bhatnagar

MAY 11, 2022

A 55 years old diabetic male patient who had 12 stents in his heart underwent a successful beating heart bypass surgery under Dr. Prateek Bhatnagar, Director Cardiac Surgery. The patient was suffering with angina (chest pain) since 2002. He was now getting chest pain even at rest and his life was at grave risk.

Stent 52

Stent Stents Chest Pain Diabetes 52

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. <0.049 ng/mL).

Chest Pain 131

Chest Pain Myocardial Infarction Blog Stent 131

Dr. Smith's ECG Blog

SEPTEMBER 5, 2024

Because previous ischemia induces myocardial preconditioning, decreasing the likelihood of transmural myocardial necrosis and myocardial rupture, patients with evidence of diabetes mellitus, chronic angina or previous MI are less likely to experience a rupture. Not all patients with acute ( or recent ) MI have chest pain with their event.

Cardiogenic Shock 109

Cardiogenic Shock Pericarditis Chest Pain Myocardial Infarction 109

Circulation

NOVEMBER 11, 2024

Introduction:Over 6 million patients (pts) present to US emergency departments annually with chest pain (CP), of which the majority are found to have no serious disease. Evaluation of these pts results in substantial costs for unnecessary hospitalization and extensive testing. Length of stay (LOS) in the CPU to discharge was 10.4

Chest Pain 40

Chest Pain ACE Inhibitor Cardiac Function Coronary Artery Disease 40

Open Heart

AUGUST 25, 2024

Multivariable Cox models, adjusted for clinical and imaging variables, showed that diabetes (HR: 2.38; p=0.008), HEART score of 3 (HR: 1.32; p=0.01), history of coronary artery disease (HR: 2.75; p=0.003), ECG changes (HR: 5.11; p<0.0001) and abnormal NISI (HR: 16.4;

Chest Pain 52

Chest Pain Coronary Artery Disease Myocardial Infarction Electrocardiogram 52

DAIC

JULY 23, 2024

Haechan Cho, MD received Best Abstract first runner-up after presenting his abstract, “Coronary Computed Tomography Angiography Versus Functional Testing In Patients With Diabetes And Suspected Coronary Artery Disease: Real-world Evidence From The Nationwide Cohort.”

Chest Pain 105

Chest Pain Plaque Coronary Artery Disease Ischemia 105

Dr. Smith's ECG Blog

AUGUST 30, 2020

This ECG was texted to me with the message "A 31 year old with Diabetes and HTN complains of bilateral arm tingling and headache." If it was chest pain it would be more difficult to go with my gut on that." Never chest pain but had to treat as hypertensive emergency. There is also STE in V2. What do you think?

Diabetes 52

Diabetes Chest Pain Hypertension STEMI 52

Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

A 56 year old male with a history of diabetes, dyslipidemia, hypertension, and coronary artery disease presented to the emergency department with sudden onset weakness, fatigue, lethargy, and confusion. On the second morning of his admission, he developed 10/10 chest pain and some diaphoresis after breakfast.

Chest Pain 120

Chest Pain Blog Hospital Tachycardia 120

Dr. Smith's ECG Blog

NOVEMBER 22, 2023

Pulse was 115, BP 140/65, and afebrile He was found to have cellulitis and to be in diabetic ketoacidosis, with bicarb of 14, pH of 2.27, glucose of 381, anion gap of 18, and lactate of 2.2 While in the ED, patient developed acute dyspnea while at rest, initially not associated with chest pain.

Chest Pain 119

Chest Pain Ischemia Echocardiogram Myocardial Infarction 119

Dr. Smith's ECG Blog

FEBRUARY 2, 2013

In this case the diagnosis was easy because the patient presented very ill with known Type I diabetes and with vomiting, not chest pain. However, here are two from my files that presented with chest pain: The peaked T-waves give it away, but the ST elevation in V1 and V2 is a little known pseudoinfarction pattern.

Chest Pain 52

Chest Pain Ischemia Diabetes 52

Dr. Smith's ECG Blog

MAY 13, 2024

Chest Pain – Benign Early Repol or OMI? Written by Destiny Folk, MD, Adam Engberg, MD, and Vitaliy Belyshev MD A man in his early 60s with a past medical history of hypertension, type 2 diabetes, obesity, and hyperlipidemia presented to the emergency department for evaluation of chest pain.

Chest Pain 120

Chest Pain STEMI Ultrasound Heart attacks 120

The British Journal of Cardiology

FEBRUARY 20, 2024

We found that a history of hypertension and diabetes are independent determinants of having a high-risk CAC score. There were 127 patients (11.2%) classified as high risk (CAC ≥400). Furthermore, this study demonstrated protective effects associated with physical activity and diastolic blood pressure.

Blood Pressure 52

Blood Pressure Chest Pain Atherosclerosis Diabetes 52

ECG Guru

APRIL 4, 2023

The Patient: This series of ECGs is from a 65-year-old woman who was complaining of a sudden onset of chest pain, nausea, and weakness. She stated that the pain increased on inspiration. She reported a history of non-insulin-dependent diabetes mellitus (NIDDM). In chest pain, possible M.I.,

Chest Pain 52

Chest Pain Diabetes 52

DAIC

APRIL 2, 2025

Patients with coronary artery diseaseplaque buildup inside the arteries that leads to chest pain, shortness of breath, and heart attackoften undergo PCI, a non-surgical procedure in which interventional cardiologists use a catheter to place stents in the blocked coronary arteries to restore blood flow.

Stent 40

Stent Stents Outcomes Coronary Angiogram 40

Dr. Anish Koka

MAY 16, 2023

This means that at every age, the probability a man complaining of chest pain has significant underlying coronary disease as a cause of this chest pain is much higher than a woman complaining of chest pain. Thanks for reading Dr. The data is overwhelming every way you can possibly look at it.

Chest Pain 52

Chest Pain Coronary Artery Disease Cancer Heart Attack 52

Dr. Smith's ECG Blog

DECEMBER 6, 2022

A 65 year old with diabetes presented with a syncopal episode while sitting, associated with weakness but no chest pain or shortness of breath. S yncope is an uncommon presentation of ACS, but anginal equivalents are more likely in older patients with diabetes 2. PEARL #1: Not all patients with acute MI report chest pain.

Chest Pain 52

Chest Pain STEMI Diabetes Circulation 52

Dr. Smith's ECG Blog

OCTOBER 22, 2024

This was sent to me by a French colleague, Olivier Peyronie "Yesterday we received a 62 yo man with diabetes, hypertension and smoker. He reported typical chest pain since 4H AM and arrived at our ED at 10h with ongoing chest pain. You must record frequent serial ECGs for patients with chest pain.

Chest Pain 66

Chest Pain STEMI Myocardial Infarction Angioplasty 66

MIBHS

OCTOBER 31, 2024

Monitor cholesterol levels and manage conditions like diabetes that can strain the heart. Exercise regularly to keep the heart strong and healthy. Avoid excessive alcohol and drug use. See a doctor regularly to detect and treat any early signs of heart disease.

Blood Pressure 52

Blood Pressure Blood Clot Heart Valves Heart Rhythm 52

DAIC

FEBRUARY 29, 2024

12:15 p.m.

Aortic valve 103

Aortic valve Myocardial Infarction Aortic Blood Pressure 103

Dr. Smith's ECG Blog

OCTOBER 20, 2024

Written by Magnus Nossen The patient in today's case is a male in his 70s with hypertension and type II diabetes mellitus. He woke up alert and with chest pain which he also had experienced intermittently over the previous few days. The syncope lasted about 2-3 minutes according to his wife.

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Wellnest

MARCH 12, 2023

Chest pain and discomfort, shortness of breath, exhaustion, lightheadedness, vertigo, ankle or leg oedema, and irregular pulse are some early warning signs of heart disease that are frequently experienced. Headaches Headaches might signify heart disease when accompanied by additional symptoms like shortness of breath or chest pain.

Heart Disease 52

Heart Disease Heart Attack Heart attacks Blood Pressure 52

DAIC

APRIL 1, 2024

Most cases go undiagnosed until the condition advances enough to create symptoms such as shortness of breath, chest pain or fatigue. Valvular heart disease, a condition in which any of the heart’s four valves are damaged or diseased, afflicts 2.5 percent of all Americans and 13 percent of Americans over age 80.

Technology 105

Technology Heart Disease Innovation Ultrasound 105

Dr. Smith's ECG Blog

DECEMBER 29, 2018

Written by Pendell Meyers A male in his 50s with history of HTN, DM, HLD presented with chest pain of less than one hour duration. Here is a repeat ECG 45 minutes later with persistent chest pain: Obviously progressing into a clear STEMI. Here is his triage ECG: What do you think? The ECG was interpreted as non-ischemic.

Chest Pain 52

Chest Pain STEMI Diabetes Hypertension 52

Dr. Smith's ECG Blog

AUGUST 26, 2019

Written by Pendell Meyers A woman in her 70s with diabetes, hypertension, and hyperlipidemia suddenly developed nausea, diaphoresis, and brief syncope while eating at a restaurant. She did not report any chest pain or pressure. A male in his 60s with chest pain A Male in his 60s with Chest pain.

Chest Pain 52

Chest Pain STEMI Biomarkers Article 52

Dr. Smith's ECG Blog

OCTOBER 26, 2011

This 57 yo diabetic male presented with generalized fatigue, myalgias, and arthralgias , mild subjective fever and chills, and nausea. He also stated his arms and head feel "heavy" and he had a headache, dry heaves, and dizziness, and some "indigestion" in his chest "like acid". He had been awakened by cough at 3 AM 2 days earlier.

STEMI 52

STEMI Chest Pain Myocardial Infarction Angioplasty 52

Dr. Smith's ECG Blog

APRIL 20, 2018

female with HTN, HLD, diabetes, ESRD on dialysis is brought in by EMS with sudden onset, left -sided chest pain for the past four hours. While she was in her bed at home, she had sudden onset of left sided chest pain that radiated to her shoulder. The pain was pleuritic, without nausea or diaphoresis.

Chest Pain 40

Chest Pain Ultrasound Risk Factors STEMI 40