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Opiate overdose, without chest pain or shortness of breath. Cognitive dissonance.

Dr. Smith's ECG Blog

Upon questioning patient, he denies having any chest pain or chest tightness of any sort. In the absence of chest pain and negative troponin , it appears less likely that he is having acute coronary syndrome though EKG appears concerning. Pericarditis would be even more unlikely in someone without chest pain.

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An elderly male with shortness of breath

Dr. Smith's ECG Blog

He reports significant chest pain at the base of his scapula on the right side along with new shortness of breath. First troponin I returns at 48 ng/L ECG 5 143 min No significant change ECG 6 261 min Same hs Troponin I profile (peaked at 1849): Formal Echocardiogram SUMMARY The estimated left ventricular ejection fraction is 74 %.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

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).

Plaque 52
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An athletic 30-something woman with acute substernal chest pressure

Dr. Smith's ECG Blog

These are reperfusion T-waves (the same thing as Wellens' waves) Echocardiogram Regional wall motion abnormality-distal septum and apex. She has done quite a bit of research on the topic. Given that chest pain is resolving at the time ECG #2 was recorded — this supports the concept of dynamic ST-T wave changes in this patient.

SCAD 52
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Beta Blockers May Not Benefit Many Heart Attack Survivors

DAIC

However, researchers said that the clinical trials that led to this routine use of beta blockers were conducted before the advent of many newer procedures that are now widely used to open blocked arteries. The researchers plan to separately analyze outcomes related to quality of life and sexual health.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

I remember Allie well from her days in the Research volunteer program at Hennepin. A formal echocardiogram was completed the next day and again showed a normal ejection fraction without any focal wall motion abnormalities to suggest CAD. It was from a patient with chest pain: Note the obvious Brugada pattern.

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A COVID19 vaccine exemption letter

Dr. Anish Koka

He was concerned because he had chest pain after his first mRNA vaccine and was uncomfortable with the risks of a second mRNA dose. He subsequently describes having sharp chest pain over the next few weeks. The pain resolved a few weeks later. He emphatically denies any history of cardiopulmonary disease.