Dr. Smith's ECG Blog

OCTOBER 1, 2023

A man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. He had active chest pain at the time of triage at 0137 at night, with this triage ECG: What do you think? Chest x-ray was normal.

Stents 127

Stents Stent STEMI Physiology 127

All About Cardiovascular System and Disorders

APRIL 17, 2024

Conventional coronary angiograms are obtained by injecting medications directly into the coronary arteries and imaging them with X-ray equipment in cardiac catheterization laboratory. CT coronary angiogram is useful to rule out significant blocks in in those presenting with chest pain to the emergency department.

Coronary Angiogram 40

Coronary Angiogram Catheterization Laboratory Angioplasty Chest Pain 40

Dr. Smith's ECG Blog

AUGUST 26, 2009

This is a 58 year old male with 40 minutes of chest pain of acute onset. He was given aspirin and sublingual nitroglycerine, which improved his pain. Methods : We searched the catheterization laboratory database for all cases coded as acute Inferior STEMI from January 2002 through March 2008.

STEMI 52

STEMI Catheterization Laboratory Chest Pain Myocardial Infarction 52

Dr. Smith's ECG Blog

OCTOBER 18, 2023

The chest pain quickly subsided. mmol, magnesium 0,79mmol (laboratory ref value 0,71-0,94) The patient was given magnesium sulfate 10 mmol (2,4g) iv infusion over 10 minutes post ROSC, due to TdP arrest. The T-waves have more area under the curve than baseline, but don't appear like typical hyperacute T waves.

Cardiac Arrest 122

Cardiac Arrest Tachycardia Cardiomyopathy Bradycardia 122

Dr. Smith's ECG Blog

OCTOBER 6, 2018

We knew only that the ECG belonged to a man in his 50s with chest pain and normal vitals. The day prior to presentation (about 12 hours prior to presentation) he described sudden onset chest pain and shortness of breath while gardening in his back yard. He had no further pain and went to bed that night with no complaints.

Chest Pain 40

Chest Pain STEMI Myocardial Infarction Coronary Artery Disease 40

Dr. Smith's ECG Blog

DECEMBER 29, 2015

What do you think of this ECG in a patient with chest pain? Case history A middle-aged woman with a history of HTN, but no prior CAD, presented to the ED with chest pain. The pain had been mild and intermittent for 2 weeks, but had become more intense on the night of presentation. Is the ST elevation due to LVH?

STEMI 40

STEMI Myocardial Infarction Chest Pain Aneurysm 40

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. Mitral valve calcification with mild regurgitation Laboratory data (pre-procedure) 1. Troponin I 2.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

FEBRUARY 18, 2022

In fact, there is laboratory evidence that CO toxicity increases Plateletneutrophil aggregates and plasma myeloperoxidase (MPO) concentration and thus may precipitate ACS (though this is by no means clinically proven). See this case of an awake patient without chest pain but with a CO level of 34%: CO poisoning.

Ischemia 52

Ischemia Blog Chest Pain Laboratory 52

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? Electrical alternans — was first observed in the laboratory by Herring in 1909. She was noted to be tachycardic and her heart sounds were distant on physical exam.

Tachycardia 40

Tachycardia Pericarditis Ultrasound Blood Pressure 40

Frontiers in Cardiovascular Medicine

JANUARY 2, 2024

Background Despite the crucial role of Chest pain centers (CPCs) in acute myocardial infarction (AMI) management, China's mortality rate for ST-segment elevation myocardial infarction (STEMI) has remained stagnant. The cohort was stratified by Killip classification at admission (Class 1: n  = 402, Class ≥2: n  = 262).

Chest Pain 59

Chest Pain Myocardial Infarction COVID-19 Catheterization Laboratory 59

Heart BMJ

JANUARY 10, 2024

An adult patient presented with palpitations, chest pain and reduced exertional capacity for 3 years. Laboratory tests revealed an elevated N-terminal pro-brain natriuretic peptide (NT-proBNP), normal high-sensitivity troponin T and severe hypertriglyceridaemia. Blood pressure was elevated.

Sudden Cardiac Death 40

Sudden Cardiac Death Chest Pain Blood Pressure Laboratory 40

Dr. Smith's ECG Blog

MAY 5, 2022

He denied any chest pain or shortness of breath and stated he felt at his baseline yesterday prior to drug use. They recommended repeating his ECG and awaiting troponin since the patient did not have any chest pain. He complained of generalized weakness and left lower extremity numbness. Creatinine elevated at 3.09

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 52

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. The final bit of bad news relates to the common laboratory and imaging tests cardiologists typically use to assess for heart dysfunction.

COVID-19 52

COVID-19 Hospital Chest Pain Quality of Life 52

Dr. Smith's ECG Blog

APRIL 8, 2016

A late middle-aged man presented with one hour of chest pain. Be certain that your laboratory value is accurate and that it corresponds with the ECG findings! He had significant history of CAD with CABG x5, and repeat CABG x 2 as well as a subsequent PCI of the graft to the RCA (twice) and of the graft to the Diagonal.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Wellnest

JULY 19, 2023

When a person experiences a heart attack or myocardial infarction, they may feel chest pain and other symptoms in different parts of their body. The only requirement is that it can be performed only in facilities with a cardiac catheterization laboratory and well-versed clinicians in this operation.

Heart attacks 52

Heart attacks Heart Attack Blood Pressure Myocardial Infarction 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.

Arrhythmia 52

Arrhythmia Outcomes Chest Pain Risk Factors 52

Frontiers in Cardiovascular Medicine

JANUARY 8, 2025

Herein, we report a case of painful LBBB syndrome complicated with VVS, which was misdiagnosed as acute coronary syndrome and cardiogenic shock.Case summaryA 62-year-old woman presented with intermittent exertional chest pain for 3years and deteriorated for 2weeks. Coronary angiography showed no evidence of obstructive lesions.

Chest Pain 52

Chest Pain Angina Coronary Artery Disease Blood Pressure 52

Frontiers in Cardiovascular Medicine

MARCH 14, 2025

Despite standardized coronary intervention and anticoagulant/antiplatelet therapy, the patient reported intermittent chest discomfort with persistently elevated cardiac troponin and d-dimer levels 20 days after initial treatment.

Myocardial Infarction 52

Myocardial Infarction Thrombosis Chest Pain Coronary Artery Disease 52

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. The patient was given aspirin 325 mg and laboratory workup was initiated.

STEMI 81

STEMI Chest Pain Myocardial Infarction Document 81

Dr. Smith's ECG Blog

FEBRUARY 2, 2025

Written by Pendell Meyers A man in his 60s presented with acute chest pain. Troponin I quickly exceeded the laboratory limit of reporting at 25,000 ng/L. Here is his triage ECG: What do you think? There is sinus rhythm with clear LVH. 4 days later: Continued reperfusion.

Cardiac Arrest 86

Cardiac Arrest STEMI Blog Ischemia 86

Open Heart

DECEMBER 2, 2024

Evaluating its diagnostic performance against laboratory standards is imperative, given the variations in cardiac troponin levels across populations. Results The point-of-care and laboratory assays exhibited equivalent sensitivity and negative predictive values (both 100%) for blood samples collected at both time points.

Chest Pain 98

Chest Pain Laboratory Myocardial Infarction Outcomes 98

Open Heart

DECEMBER 3, 2024

The aim of the current study is to assess the association of laboratory markers, late gadolinium enhancement (LGE) and left ventricular ejection fraction (LVEF) in patients with acute myocarditis. Results 127 patients had abnormal T2-weighted imaging/mapping results with 118 (93%) presenting with chest pain and/or shortness of breath.

Chest Pain 52

Chest Pain Laboratory Diabetes Risk Factors 52