Heart BMJ

AUGUST 14, 2024

He was admitted to our hospital with issues of chest pain, shortness of breath and heart palpitations without any obvious inducement. Figure 1 Transthoracic echocardiogram. (A) He had no medical history of myocardial infarction (MI). A 12-lead ECG indicated sinus rhythm with a heart rate of 78 bpm.

Aneurysm 52

Aneurysm Chest Pain Myocardial Infarction Thrombosis 52

HeartRhythm

SEPTEMBER 8, 2024

While in the hospital, he had witnessed ventricular fibrillation (VF) arrest for which he received external defibrillation. An echocardiogram showed newly reduced left ventricular ejection fraction of 30-35%.

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Defibrillator Pacemaker Chest Pain Coronary Artery Disease 40

Dr. Smith's ECG Blog

OCTOBER 15, 2024

He arrived to the ED by helicopter at 1507, about three hours after the start of his chest pain while chopping wood around noon. He arrived to the ED by ambulance at 1529, only a half hour after the start of his chest pain around 1500 while eating. Patient 1 remained in the hospital overnight.

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Chest Pain STEMI Echocardiogram Stents 116

Dr. Smith's ECG Blog

JULY 14, 2023

So we activated the Cath Lab Angiogram: Impression and Recommendations: Culprit for the patient's anterior ST segment myocardial infarction and out of hospital V-fib cardiac arrest is a thrombotic occlusion of the mid LAD The first troponin returned barely elevated at 36 ng/L (URL = 35) In our study of initial troponin in STEMI, 26.8%

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Cardiac Arrest Chest Pain Defibrillator Atrial Flutter 98

Dr. Smith's ECG Blog

JUNE 18, 2011

3 hours prior to calling 911 he developed typical chest pain. When flow is restored, wall motion may completely recover so that echocardiogram does not detect the previous ischemia. Pain was typical for MI (substernal, not postional or sharp, resolved with NTG) b. Transient ST elevation is very hazardous.

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STEMI Pericarditis Hospital Aneurysm 52

Dr. Smith's ECG Blog

JULY 11, 2024

No patient with chest pain should be sent home without troponin testing. An echocardiogram showed severely reduced global systolic function with an EF of 20-25% and an LV apical thrombus. An echocardiogram showed an EF of 20-25%. Here is the post-cath EKG: There is no change. The LV aneurysm morphology persists.

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Outcomes Stenosis Outpatient Echocardiogram 112

Wellnest

DECEMBER 31, 2023

Yes, COVID-19 symptoms can resemble a heart attack, including chest pain, shortness of breath, and changes in echocardiogram or EKG. Myocarditis symptoms can also mimic a heart attack, and small blood clots may cause pain. Can COVID-19 symptoms mimic a heart attack?

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COVID-19 Heart Attack Heart attacks Exercise 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Hopefully a repeat echocardiogram will be performed outpatient. ECG of pneumopericardium and probable myocardial contusion shows typical pericarditis Male in 30's, 2 days after Motor Vehicle Collsion, complains of Chest Pain and Dyspnea Head On Motor Vehicle Collision. 1900: RBBB and LAFB are almost fully resolved.

Tachycardia 115

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 115

Ken Grauer, MD

JANUARY 13, 2024

On the other hand — the ST elevation seen in lead V1 is perfectly consistent with LVH and LV "strain" ( ie, The shape of this ST-T wave in lead V1, in association with the deep S wave in this lead — is a mirror-image opposite picture of the typical expected appearance of LVH with "strain" in a lateral chest lead ).

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Blog Ischemia AFIB Hypertension 158

Dr. Smith's ECG Blog

JUNE 18, 2013

This was my thought: if this patient presented to the ED with chest pain, then this is an LAD occlusion. He was admitted to the hospital for a "rule out." On echocardiogram, there was a 40% ejection fraction with anterior wall motion abnormality. His first troponin was normal. The peak troponin I was over 100.

STEMI 52

STEMI Chest Pain Myocardial Infarction Webinar 52

Dr. Smith's ECG Blog

JANUARY 1, 2024

The patient was promptly admitted to the hospital for further evaluation. Although the patient reported experiencing mild pressure-like chest pain, there was suspicion among clinicians that this might be indicative of an older change. An initial electrocardiogram (ECG) is provided below. What do you think? What is the rhythm?

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Tachycardia Blog Ischemia Heart Failure 112

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. This is her pre-hospital ECG: This is her first ECG in the ED: What do you think? While she was in her bed at home, she had sudden onset of left sided chest pain that radiated to her shoulder.

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Chest Pain Ultrasound Risk Factors STEMI 40

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. It is also NOT the clinical scenario of takotsubo (a week of intermittent chest pain).

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Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

JULY 31, 2018

Post by Smith, with short article by Angie Lobo ( [link] ), a third year intermal medicine resident at Abbott Northwestern Hospital Case A 30-something woman with no past history, who is very fit and athletic, presented with 1.5 hours of substernal chest pressure. She had zero CAD risk factors. It is equivalent to a transient STEMI.

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SCAD Chest Pain Myocardial Infarction Ischemia 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chest pain to Dr. McLaren. See this case: what do you think the echocardiogram shows in this case?

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Ischemia STEMI Stenosis Chest Pain 52

EMS 12-Lead

JULY 24, 2023

But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chest pain was a little more intense, and the needed recovery period was longer in duration. Echocardiogram findings (pre-procedure) 1. A 12 Lead ECG was captured on her arrival.

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Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

OCTOBER 25, 2022

She reports that she is now unable to vagal out of her palpitations and is having shortness of breath and dull chest pain. She had an echocardiogram which was normal. She reported a prior history of SVT and has previously performed vagal maneuvers at home with symptom resolution. Her initial EKG is below.

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Tachycardia Atrial Flutter Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

JUNE 23, 2024

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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Chest Pain Cardiac Arrest Sudden Cardiac Death Blog 118

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. A transthoracic echocardiogram showed an LV EF of less than 15%, critically severe aortic stenosis , severe LVH , and a small LV cavity.

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Ischemia Cardiogenic Shock Aortic Stenosis 40

Dr. Smith's ECG Blog

JUNE 17, 2024

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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Chest Pain Embolism Pulmonary Tachycardia 138

Dr. Smith's ECG Blog

OCTOBER 2, 2021

Submitted by Benjamin Garbus, MD with edits by Bracey, Meyers, and Smith A man in his early 30s presented to the ED with chest pain described as an “explosion" of left chest pressure. He had been seen several weeks ago at an outside hospital for a similar issue and had been discharged home, presumably after unremarkable workup.

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Chest Pain Ultrasound STEMI Myocardial Infarction 52

Dr. Smith's ECG Blog

OCTOBER 22, 2024

He reported typical chest pain since 4H AM and arrived at our ED at 10h with ongoing chest pain. The echocardiogram shows a preserved left ventricular ejection fraction (LVEF) of 55% with marked basal and mid inferolateral and basal anterolateral hypokinesia. The first ECG (10h14) showed TWI in inferior leads."

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Chest Pain STEMI Myocardial Infarction Angioplasty 66

Wellnest

DECEMBER 21, 2022

However, an echocardiogram is a different test, also conducted for heart activity. Patients use them to observe their heart activity by themselves when they are not in the hospital. Electrocardiogram, echocardiogram, and some other tests are done for patients with cardiac arrest. ECG and EKG refer to the same thing.

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Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

Circulation

NOVEMBER 11, 2024

The relationship between low RHR and CI has yet to be described.Purpose:We hypothesize that resting sinus bradycardia (low RHR) could be a predictor of chronotropic incompetence and reduced exercise capacity.Methods:The derivation cohort consists of 201 patients with normal Bruce protocol treadmill stress echocardiogram. x age in years).Results:The

Exercise 40

Exercise Chest Pain Myocardial Infarction Bradycardia 40

Dr. Anish Koka

SEPTEMBER 24, 2022

The current study should dispel the ludicrous notion that clinical myocarditis - a disease entity that comes to light when you have chest pain because cells in your heart are dying — is mild. So, of the 989 cases of myocarditis that were identified via VAERS, there is information on hospitalization status for 519 of them.

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COVID-19 Hospital Chest Pain Quality of Life 52

Dr. Smith's ECG Blog

MARCH 6, 2020

This middle-aged man with no cardiac history but with significant history of methamphetamin and alcohol use presented with chest pain and SOB, worsening over days, with orthopnea. The patient was given furosemide and admitted to the hospital. BP:143/99, Pulse 109, Temp 37.2 °C C (99 °F), Resp (!)

Heart Failure 52

Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52

Dr. Anish Koka

FEBRUARY 20, 2023

He was concerned because he had chest pain after his first mRNA vaccine and was uncomfortable with the risks of a second mRNA dose. The vast majority of cases of vaccine myocarditis requires hospitalization for monitoring for deterioration. He subsequently describes having sharp chest pain over the next few weeks.

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COVID-19 Pericarditis Chest Pain Public Health 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. Del Rosso A, et al.

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Arrhythmia Outcomes Chest Pain Risk Factors 52

Dr. Smith's ECG Blog

MARCH 3, 2025

A 69 year old woman with a history of hypertension presented to the emergency department by EMS for evaluation of chest pain and shortness of breath. She awoke in the morning with sharp chest pain which worsened throughout the morning. As her pain worsened, so did her dyspnea. This was written by Hans Helseth.

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Tachycardia Pulmonary Chest Pain Stenosis 73

Dr. Smith's ECG Blog

MARCH 17, 2025

Written by Willy Frick A man in his 60s with a history of hypertension and 40 pack-year history presented to the ER with 1 day of intermittent, burning substernal chest pain radiating into both arms as well as his back and jaw. Echocardiogram showed inferior hypokinesis. Troponin was rising when last checked, 8928 ng/L.

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STEMI Chest Pain Myocardial Infarction Document 81

Dr. Smith's ECG Blog

JANUARY 21, 2025

He denied chest pain. In this study of consecutive patients with LBBB who were hospitalized and had an echocardiogram, a QRS duration less than 170 ms (n = 262), vs. greater than 170 ms (n = 38), was associated with a significantly better ejection fraction (36% vs. 24%). And here the lines show the offset.

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Chest Pain STEMI Tachycardia Myocardial Infarction 61