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. 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.

Stents 52

Stents Stent 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 130

Chest Pain Myocardial Infarction Blog Stent 130

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 Chest Pain Pericarditis Myocardial Infarction 109

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 Coronary Artery Disease Plaque 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 118

Chest Pain Ischemia Echocardiogram Myocardial Infarction 118

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

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

FEBRUARY 29, 2024

12:15 p.m.

Aortic valve 103

Aortic valve Myocardial Infarction Aortic Blood Pressure 103

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 Hypertension Diabetes 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

AMS Cardiology

AUGUST 15, 2023

Diabetes – People with diabetes are at an increased risk due to the potential damage high blood sugar can cause to blood vessels and nerves. Obesity and poor diet – Being overweight coupled with other risk factors can lead to heart problems. While some symptoms may be subtle and easily overlooked, others can be apparent.

Heart Disease 52

Heart Disease Blood Pressure Risk Factors Cholesterol 52

Stroke Journal

JANUARY 30, 2025

In unadjusted analysis, factors significantly associated with troponin testing were a triage complaint of chest pain, older age, higher mean systolic BP, hypertension, diabetes, obesity, stroke or TIA, congestive heart failure, or coronary disease. In suspected stroke patients, 26.1% (95% CI, 20.9-32.2%)

Stroke 40

Stroke Strokes Chest Pain Myocardial Infarction 40

Circulation

NOVEMBER 11, 2024

We present a complex case of NSTEMI with multi-vessel coronary artery disease treated with PCI via the Carlino technique.Case Description:A 60-year-old female with a history of hypertension, diabetes mellitus, and ischemic heart disease presented with severe chest pain that radiated to the neck and was associated with nausea and vomiting.

Coronary Artery Disease 40

Coronary Artery Disease Chest Pain Myocardial Infarction Thrombolysis 40

Dr. Smith's ECG Blog

JUNE 17, 2017

The above is what I thought when I saw this, so I went to the chart and found this history: A type I diabetic aged approximately 35 years old presented with chest pain, nausea, vomiting and diffuse abdominal pain. The patient was in DKA with an anion gap of 35, a glucose of 1128, and a K of 5.5

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Stent 52

Dr. Smith's ECG Blog

FEBRUARY 14, 2020

Written by Pendell Meyers, sent by Anonymous A man in his 50s with history of type 2 diabetes, HTN, and HLD presented with one day of off and on chest / upper abdominal pain. It had awoken him from sleep earlier, and he described it as "gas pain," located in the upper epigastrium and radiating upwards.

Chest Pain 52

Chest Pain STEMI Anatomy Risk Factors 52

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

This was a male in his 50's with a history of hypertension and possible diabetes mellitus who presented to the emergency department with a history of squeezing chest pain, lasting 5 minutes at a time, with several episodes over the past couple of months. Plan was for admission for chest pain workup.

Chest Pain 52

Chest Pain Thrombosis Myocardial Infarction STEMI 52

Dr. Smith's ECG Blog

SEPTEMBER 21, 2022

A 40-something woman with diabetes and peripheral vascular disease who frequently needs the ED for chronic pain called 911 for sudden severe chest pain. The patient was very agitated and could not hold still. I greeted medics at the door to view the prehospital ECG.

Chest Pain 52

Chest Pain Blog Ischemia STEMI 52

Dr. Smith's ECG Blog

JANUARY 1, 2024

His medical history includes hypertension, a decade-long battle with diabetes, ischemic heart disease, a coronary bypass graft surgery ten years ago, a diagnosis of congestive heart failure for the last five years, and a prior ICD implantation five years ago. There is some ST-segment elevation in DII, DIII, aVF, V4-6.

Tachycardia 112

Tachycardia Blog Ischemia Heart Failure 112

All About Cardiovascular System and Disorders

JULY 21, 2024

As age advances and depending on risk factors like heredity, smoking, high blood pressure and diabetes, fat build up occurs in these blood vessels. This can block smooth flow of blood and the person can develop chest pain. Coronary arteries are blood vessels supplying oxygenated blood to the heart.

Coronary Artery Bypass Graft 40

Coronary Artery Bypass Graft Angioplasty Cardiac Rehabilitation Chest Pain 40

Dr. Smith's ECG Blog

NOVEMBER 13, 2022

A 50 something-year-old man with a history of newly diagnosed hypertension and diabetes, for which he did not take any medication, presented a non-PCI-capable center with a vague, but central chest pain. He is an interventionalist in Turkey. A second ECG was taken at 15:16. Wait for the angiogram.

Chest Pain 52

Chest Pain Myocardial Infarction Blog Pericarditis 52

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. The patient was in his 50s with history of hypertension, diabetes, seizure disorder, and smoking, but no known coronary artery disease. He went inside and sat down, and the pain slowly subsided over the course of about 30 minutes.

Chest Pain 40

Chest Pain STEMI Myocardial Infarction Coronary Artery Disease 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

The gradual loss of elasticity in arterial walls and the presence of other risk factors, such as high blood pressure and diabetes, contribute to the increased risk of cardiovascular disease (CVD) observed in aging populations. Risk factors such as smoking, chronic kidney disease, and aging can contribute to plaque formation.

Risk Factors 40

Risk Factors Blood Pressure Chest Pain Plaque 40

Dr. Smith's ECG Blog

JANUARY 5, 2024

Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." The patient said his chest pain was 4/10, down from 8/10 on presentation. The documentation does not describe any additional details of the history. ECG 1 What do you think?

Angina 120

Angina Plaque Document Stent 120

Dr. Smith's ECG Blog

JULY 1, 2019

Case 2: sent by Dr. James Alva A man in his 50s with diabetes, hypertension, and hyperlipidemia presented to the ED with chest pain and shortness of breath off and on over the past three days, with associated vomiting. All previous ECGs were identical. This was her baseline ST elevation, and I have seen this many times.

Chest Pain 52

Chest Pain Ischemia STEMI Blog 52

Dr. Sanjay Gupta

AUGUST 31, 2022

These include breathlessness, chest pain, dizziness or even blackouts. Dysrhythmias are more likely in patients who are older and sicker with a larger burden of comorbidities such as diabetes, high blood pressure, sleep apnoea and vascular disease. There are two other important points to note.

Arrhythmia 52

Arrhythmia Dysrhythmia Heart Rhythm Chest Pain 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. He described it as "10/10" intensity, radiating across his chest from right to left.

Plaque 127

Plaque Angina Blog Stent 127

Dr. Smith's ECG Blog

FEBRUARY 29, 2016

A middle-aged diabetic dialysis patient presented with 24 hours of nausea and vomiting associated with ~6 pound weight loss. He denied fevers and chills, abdominal pain, chest pain, or SOB. Patient stated his dry weight is around 85 kg. The emesis is non-bloody and non-bilious. He did have one episode of diarrhea.

Aneurysm 52

Aneurysm Ischemia Embolism STEMI 52

DAIC

DECEMBER 8, 2023

AFib causes a variety of symptoms, including fast or chaotic heartbeat, fatigue, shortness of breath, and chest pain, and causes about 450,000 hospitalizations each year, according to the Centers for Disease Control and Prevention.

Atrial Fibrillation 52

Atrial Fibrillation AFIB Stroke Strokes 52