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Three prehospital ECGs in patients with chest pain

Dr. Smith's ECG Blog

Written by Magnus Nossen with Edits by Grauer and Smith The ECGs in today’s case are from 3 different patients all presenting with new-onset CP ( Chest Pain ). Despite active CP — cath lab activation was deferred and this patient was transported to a local hospital without PCI capability.

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VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

He was intubated in the field and sedated upon arrival at the hospital. Echocardiogram showed LVEF 66% with normal wall motion and normal diastolic function. He did not remember whether he had experienced any chest pain. At his family's request, he was transferred to a hospital closer to his home to continue care.

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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage.

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A man in his 70s with chest pain during a bike ride

Dr. Smith's ECG Blog

Case written and submitted by Ryan Barnicle MD, with edits by Pendell Meyers While vacationing on one of the islands off the northeast coast, a healthy 70ish year old male presented to the island health center for an evaluation of chest pain. The chest pain started about one hour prior to arrival while bike riding.

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Infection and DKA, then sudden dyspnea while in the ED

Dr. Smith's ECG Blog

He was treated for infection and DKA and admission to hospital was planned. While in the ED, patient developed acute dyspnea while at rest, initially not associated with chest pain. He later developed mild continuous chest pain, that he describes as the sensation of someone standing on his chest.

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Unexpected finding on imaging: an aortic valve mass

Heart BMJ

After 24 hours, the patient was readmitted to the hospital with chest pain and troponin elevation, without ECG changes. A transthoracic echocardiogram (TTE) revealed a mobile mass on the right coronary cusp of the aortic valve ( figure 1 , ). The patient was discharged and apixaban was restarted 10 hours later.

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Syncope While Driving. Activate the Cath Lab?

Dr. Smith's ECG Blog

The medics stated he had been nauseated and diaphoretic, but he did not have any chest pain or SOB. And especially suspect Old MI when the patient gives a history of MI and has no chest pain or SOB. Case continued The patient underwent an emergency formal echocardiogram and it was unchanged. Learning Points: 1.

Aneurysm 115