Dr. Smith's ECG Blog

DECEMBER 18, 2022

Submitted and written by Quinton Nannet, MD, peer reviewed by Meyers, Grauer, Smith A woman in her 70s recently diagnosed with COVID was brought in by EMS after she experienced acute onset sharp midsternal chest pain without radiation or dyspnea. She felt nauseous and lightheaded with no neurologic deficits.

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Dr. Smith's ECG Blog

JUNE 18, 2011

3 hours prior to calling 911 he developed typical chest pain. This rules out pericarditis, which essentially never has reciprocal ST depression. This is not pericarditis because: a. Pain was typical for MI (substernal, not postional or sharp, resolved with NTG) b. Pericarditis does not have reciprocal depression.

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Dr. Anish Koka

JANUARY 1, 2023

The case reports Case 1 involves a 26 year old man who developed pericarditis after the Pfizer vaccine. Pericarditis, an inflammation of the sac the heart lives in, developed about 7 days after the Pfizer vaccine. The diagnosis was made based on classic findings of inflammation on an electrocardiogram associated with acute chest pain.

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Circulation: Arrhythmia and Electrophysiology

DECEMBER 21, 2023

Postablation chest pain consistent with pericarditis was reduced with colchicine (4% versus 15%; HR, 0.26 [95% CI, 0.09–0.77];P=0.02) Colchicine did not prevent atrial arrhythmia recurrence at 2 weeks (31% versus 32%; hazard ratio [HR], 0.98 [95% CI, 0.59–1.61];P=0.92) 2.02];P=0.89). 11.53];P<0.001). 1.99];P=0.55).CONCLUSIONS:Colchicine

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Dr. Smith's ECG Blog

NOVEMBER 25, 2017

Written by Pendell Meyers, edits by Smith: Case A 72 year old female with hypertension and COPD presented with sudden shortness of breath and chest pain. On day 3 of hospitalization she underwent coronary angiography, revealing a 95% lesion in the mid-LAD which was stented. There is sinus rhythm with PACs and PVCs.

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Dr. Smith's ECG Blog

FEBRUARY 6, 2024

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. Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated. ST depression. Myocardial Contusion?

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Tachycardia Dysrhythmia Bradycardia Atrial Fibrillation 114

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. Such an out-of-proportion STE is virtually never seen in pericarditis. He arrived to our hospital one hour later.

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Dr. Smith's ECG Blog

MARCH 11, 2019

You do NOT see this in normal variant STE, nor in pericarditis. After admission to the hospital, the patient was discharged from the hospital without any investigation of his acute MI. At some point he returned with chest pain, and all these findings were put into place. Many MI do not have chest pain 4.

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Chest Pain Ischemia Aneurysm Myocardial Infarction 52

Ken Grauer, MD

APRIL 23, 2023

No chest pain. In a previously healthy adolescent ( who is 15 years old in today's case ) — the presentation of an acute febrile illness that is without a complaint of chest pain, is highly unlikely to be due to an acute MI. He was hemodynamically stable. How would YOU interpret the ECG in Figure-1 ?

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Blog Chest Pain Arrhythmia Download 78

Dr. Smith's ECG Blog

MARCH 3, 2023

Additionally, the App also includes a chest pain section, namely EDACS risk score, which is already a well known and validated tool for the approach to acute chest pain (many thanks for its developers and their courtesy for letting us to use it in our App, Martin Than, MD; John Pickering, BSc, PhD, BA and Dylan Flaws, MSc, PhD).

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Ken Grauer, MD

SEPTEMBER 21, 2024

For example, considering whatever symptoms that the patient may have had ( ie, chest pain, palpitations, shortness of breath, etc. ) — what this might mean in view of the ECG we are looking at. The patient arrested outside the hospital. KEY Points: Use of this systematic 2-Step approach does not slow you down.

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Chest Pain Blog Thrombosis Risk Factors 120

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Given her reported chest pain, shortness of breath, and syncope, an ECG was quickly obtained: What do you think? She was discharged after a short hospitalization with oncology and cardiology follow-up. The second most common cause of medical cardiac tamponade is acute idiopathic pericarditis.

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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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Dr. Smith's ECG Blog

JANUARY 9, 2023

No prior exertional complaints of chest pain, dizziness, lightheadedness, or undue shortness of breath. He denied headache or neck pain associated with exertion. I sent this ECG to Dr. Smith, with the only information that it is a 17 year old with chest pain. 24 yo woman with chest pain: Is this STEMI?

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Dr. Smith's ECG Blog

OCTOBER 17, 2022

In fact, there was no chest pain either. Pericarditis? If you were thinking that this is pericarditis, that would be possible in the absence of any clinical information. However, there is zero PR depression which would be VERY unusual in pericarditis. P.S.: Acute pericarditis may produce diffuse ST elevation.

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Pericarditis Chest Pain Blog Arrhythmia 52

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. He spent almost 2 months in the hospital, and reportedly made a full neurologic recovery. He was prescribed apixaban.

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Dr. Smith's ECG Blog

MARCH 11, 2016

A middle-aged woman had intermittent angina for 48 hours, then onset of constant, crushing chest pain for 1.5 Post-infarction Regional Pericarditis (PIRP) PIRP happens when MI is transmural, all the way from subendocardium to subepicardium, thus leading to inflammation of the subepicardium (next to the pericardium).

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Dr. Smith's ECG Blog

OCTOBER 11, 2020

Apparently he denied chest pain. As always, takotsubo cardiomyopathy and focal pericarditis can mimic OMI, but takotsubo almost never mimics posterior MI, and both are diagnoses of exclusion after a negative cath. JAMA 2000) showed that 1/3 of patients with STEMI, and 1/3 of patients with NSTEMI, present without chest pain.

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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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Dr. Smith's ECG Blog

DECEMBER 5, 2023

Written by Kirsten Morrissey, MD with edits by Bracey, Grauer, Meyers, and Smith An older teen was transferred from an outside hospital with elevated serum troponin and and ECG demonstrating ST elevations. The workup at the transferring hospital yielded elevated troponin I at 18.1 He reported 1.5 mg/L and a normal WBC of 8.8.

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