Chest Pain Dysrhythmia STEMI 
Dr. Smith's ECG Blog
JUNE 14, 2017
There was apparently no syncope and he had no bony injuries, but he did complain of left sided chest pain. His chest was tender. Is there STEMI? A bedside cardiac ultrasound was normal. An ECG was recorded: Avinash was understandably confused by this ECG. He wrote: "ECG 1 - shows wide ???IVCD IVCD type rhythm ??
Dr. Smith's ECG Blog
JULY 22, 2023
He denied chest pain or shortness of breath. In the clinical context of weakness and fever, without chest pain or shortness of breath, the likelihood of Brugada pattern is obviously much higher. There were no dysrhythmias on cardiac monitor during observation. See below for PM Cardio digitized version of this.
Dr. Smith's ECG Blog
OCTOBER 10, 2022
Written by Pendell Meyers and Peter Brooks MD A man in his 30s with no known past medical history was reported to suddenly experience chest pain and shortness of breath at home in front of his family. Chest pain, SOB, Precordial T-wave inversions, and positive troponin. What is the Diagnosis? Now another, with ultrasound.
Dr. Smith's ECG Blog
MAY 27, 2012
A 90 yo with a history of orthostatic hypotension had a near syncopal event followed by chest pain. Chest pain was resolved upon arrival in the ED. In other words, after reperfusion therapy for STEMI, the appearance of AIVR is usually a good sign, meaning that the artery is reperfused. His previous ECG was normal.
Dr. Smith's ECG Blog
JULY 31, 2018
It is equivalent to a transient STEMI. Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. As emphasized by Dr. Smith — the best way to demonstrate acute ischemia is by identifying d ynamic S T- T wave c hanges in association with change in the nature of chest pain.
Dr. Smith's ECG Blog
JANUARY 30, 2019
2) The STE in V1 and V2 has an R'-wave and downsloping ST segments, very atypical for STEMI. Cardiology was consulted and they agreed that the EKG had an atypical morphology for STEMI and did not activate the cath lab. It was from a patient with chest pain: Note the obvious Brugada pattern. Bicarb 20, Lactate 4.2,
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. Clinical Course The paramedic activated a “Code STEMI” alert and transported the patient nearly 50 miles to the closest tertiary medical center. What do you see?
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