MIBHS

MARCH 31, 2025

A heart attack, or myocardial infarction, happens when an artery becomes blocked, reducing blood flow to the heart muscle. Raising awareness and taking proactive steps can ensure the best possible outcomes for those at risk of heart-related conditions. What is a Heart Attack?

Cardiac Arrest 52

Cardiac Arrest Heart Attack Heart attacks Chest Pain 52

Dr. Smith's ECG Blog

FEBRUARY 9, 2024

Written by Jesse McLaren A 65 year old with a history of atrial flutter, CABG and end-stage renal disease on dialysis presented with 3 days of fluctuating chest pain, which was ongoing at triage. So a patient with high pretest probability (prior CABG with new chest pain), had new ECG changes showing posterior OMI.

Chest Pain 114

Chest Pain STEMI Atrial Flutter Ischemia 114

Dr. Smith's ECG Blog

AUGUST 6, 2024

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 ). The ECG is diagnostic of occlusion myocardial infarction (OMI). All ECGs were recorded by EMS, and transferred to a PCI capable center for evaluation.

Chest Pain 104

Chest Pain Ischemia Pericarditis Tachycardia 104

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

No Chest Pain, but somnolent. The fact that this is syncope makes give it a far lower pretest probability than chest pain, but it was really more than syncope, as the patient actually underwent CPR and had hypotension on arrival of EMS. Smith : "What was the outcome?" x the QRS amplitude in any of V1-V4.

Chest Pain 114

Chest Pain Aneurysm Stents Stent 114

Dr. Smith's ECG Blog

JUNE 13, 2024

Click here to sign up for Queen of Hearts Access Case A 58-year-old woman presented to the ED with burning chest pain that started 2-3 hours earlier while sitting on a porch swing. In any case, it is diagnostic of OMI in a chest pain patient. But there is also perhaps some STD in inferior leads -- this would support LAD.

Chest Pain 92

Chest Pain Document STEMI Defibrillator 92

DAIC

APRIL 2, 2025

I suspect its use will rapidly accelerate given study after study now showing reductions in death, stent thrombosis, and nearly every other adverse outcome after PCI when intravascular imaging is used. Patients with severely calcified coronary lesions were randomized at 104 sites across the United States.

Stents 40

Stents Stent Outcomes Coronary Angiogram 40

Dr. Smith's ECG Blog

MAY 18, 2011

A 29 year old male presented with 6 hours of stuttering chest pain, constant for the last hour, worse with breathing. Take home point here : Obtain an ECG on anyone with chest pain. 3) Q-waves are independently associated with worse outcomes (78% relative increase in 90-day mortality in Armstrong et al.)

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Aneurysm 52

Dr. Smith's ECG Blog

MAY 23, 2023

Written by Pendell Meyers A man in his early 40s experienced acute onset chest pain. The chest pain started about 24 hours ago, but there was no detailed information available about whether his pain had come and gone, or what prompted him to be evaluated 24 hours after onset.

Chest Pain 98

Chest Pain STEMI Blog Stents 98

Frontiers in Cardiovascular Medicine

JANUARY 14, 2024

Background The objective of this study was to investigate the differences in presenting symptoms between patients with and without diabetes being diagnosed with an acute myocardial infarction (AMI). Results Patients with diabetes had significantly less frequent typical pain symptoms, including typical chest pain.

Myocardial Infarction 64

Myocardial Infarction Diabetes Chest Pain Risk Factors 64

Dr. Smith's ECG Blog

MAY 30, 2023

A 50-something man presented in shock with severe chest pain. Literature cited In inferior myocardial infarction, neither ST elevation in lead V1 nor ST depression in lead I are reliable findings for the diagnosis of right ventricular infarction Johanna E. The patient was in clinical shock with a lactate of 8.

Chest Pain 97

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 97

Journal of the American Heart Association

MARCH 27, 2025

BackgroundRecent evidence highlights an increasing incidence of myocardial infarction in young women. years]) admitted to the China Chest Pain Center Database between 2016 and 2021. years]) admitted to the China Chest Pain Center Database between 2016 and 2021.

Myocardial Infarction 40

Myocardial Infarction Peripheral Arterial Disease Outcomes Chest Pain 40

Frontiers in Cardiovascular Medicine

OCTOBER 8, 2024

ObjectiveAlthough the association between admission glucose (AG) and major adverse cardiac events (MACE) is well-documented, its relationship with 30-day MACE in patients presenting with cardiac chest pain remains unclarified. The average age of the patients was 65.23 ± 12.66 years, The median AG levels were 7.60 mmol/L

Chest Pain 52

Chest Pain Cardiogenic Shock Cardiac Arrest Myocardial Infarction 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2014

A male in late middle age with a history of RCA stent 8 years prior complained of chest pain. It is highly associated with proximal LAD occlusion and bad outcomes. EMS recorded the following ECG: What do you see? I have annotated it here: The lines mark the end of the QRS and beginning of the ST segment.

Chest Pain 52

Chest Pain Cardiac Arrest Myocardial Infarction Angioplasty 52

Dr. Smith's ECG Blog

MARCH 9, 2023

Sent by anonymous, written by Pendell Meyers A man in his 50s with no prior known medical history presented to the Emergency Department with severe intermittent chest pain. He denied any lightheadedness, shortness of breath, vomiting, or abdominal pain. Isn't it amazing?? hours earlier? Pol Arch Intern Med. 2017;127:401–411.

Chest Pain 52

Chest Pain STEMI Myocardial Infarction Blog 52

Dr. Smith's ECG Blog

AUGUST 3, 2017

A 70-year-old man calls 911 after experiencing sudden, severe chest pain. Electrocardiographic Manifestations: Acute posterior wall myocardial infarction. Posterior myocardial infarction: the dark side of the moon. This case comes from Sam Ghali ( @EM_RESUS ). Thanks, Sam! J Emerg Med 2001; 20:391-401.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Ischemia 52

Dr. Smith's ECG Blog

MAY 8, 2023

Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. Queen of Hearts Interpretation: Would 20 minutes earlier diagnosis have made a difference in his clinical outcome?

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Pacemaker 52

Dr. Smith's ECG Blog

JANUARY 6, 2023

Submitted and written by Anonymous, edits by Meyers and Smith A 50s-year-old patient with no known cardiac history presented at 0045 with three hours of unrelenting central chest pain. The pain was heavy, radiated to her jaw with an associated headache. Triage VS: 135/65 mmHg, 95 bpm, 94% on room air, 16/min, 98.6 Abstract 556.

Chest Pain 52

Chest Pain Ischemia Myocardial Infarction ICU 52

Dr. Smith's ECG Blog

OCTOBER 24, 2019

[link] A 30 year-old woman was brought to the ED with chest pain. She had given birth a week ago, and she had similar chest pain during her labor. She attributed the chest pain to anxiety and stress, saying "I'm just an anxious person." Lobo et al. examined SCAD presenting as STEMI (unlike Hassan et al.

Chest Pain 52

Chest Pain SCAD STEMI Cardiogenic Shock 52

Circulation: Cardiovascular Quality & Outcomes

FEBRUARY 3, 2025

Circulation: Cardiovascular Quality and Outcomes, Ahead of Print. The primary and secondary economic outcomes were total costs at 12 months and at 45 days, respectively, from the US health care system perspective.

Chest Pain 40

Chest Pain Outcomes Coronary Artery Disease Myocardial Infarction 40

Dr. Smith's ECG Blog

MAY 13, 2017

Case 1: The outcome of this case is at the far bottom. He complained of severe chest pain and was extremely agitated, so much so that he was throwing chairs in triage. Differences in electrocardiographic Findings Between Acute Isolated Right Ventricular Myocardial Infarction and Acute Anterior Myocardial Infarction.

Chest Pain 52

Chest Pain STEMI Cardiac Arrest Myocardial Infarction 52

Dr. Smith's ECG Blog

JUNE 28, 2018

He had suffered a couple bouts of typical chest pain in the last 24 hours. This ECG (ECG #3) was recorded immediately after the last episode of pain spontaneously resolved. The pain had lasted about one hour. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Article 52

Dr. Smith's ECG Blog

AUGUST 19, 2023

Because the patient had no chest pain or shortness of breath, they were initially diagnosed as gastroenteritis. But because the patient had no chest pain or shortness of breath, it was not deemed to be from ACS. But because the patient had no chest pain or shortness of breath, it was not deemed to be from ACS.

Chest Pain 98

Chest Pain STEMI Myocardial Infarction Blog 98

Dr. Smith's ECG Blog

JANUARY 23, 2023

Submitted and written by Megan Lieb, DO with edits by Bracey, Smith, Meyers, and Grauer A 50-ish year old man with ICD presented to the emergency department with substernal chest pain for 3 hours prior to arrival. At this time he reported ongoing chest pain and was given aspirin and nitroglycerin. J Am Heart Assoc.

Chest Pain 52

Chest Pain Blog Stenosis Myocardial Infarction 52

Circulation: Cardiovascular Quality & Outcomes

MAY 23, 2024

Circulation: Cardiovascular Quality and Outcomes, Ahead of Print.

Chest Pain 40

Chest Pain Myocardial Infarction Circulation Outcomes 40

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. The following ECG was obtained.

Chest Pain 131

Chest Pain Myocardial Infarction Blog Stents 131

Dr. Smith's ECG Blog

DECEMBER 16, 2019

This case was texted to me by one of our residency graduates, and with the outcome, so I don't know how I would have interpreted it blindly. A 50-something male who is healthy and active with no previous medical history presented with 5 hours of continuous worrisome chest pain. The highest ST/S ratio is in V3, and is 2.5/13

Chest Pain 52

Chest Pain Myocardial Infarction Stents Stent 52

Circulation: Cardiovascular Imaging

NOVEMBER 20, 2023

Risk ratios (RRs) and mean differences with 95% CIs were computed for binary and continuous outcomes, respectively.RESULTS:Five randomized controlled trials with a total of 5727 patients were included, of whom 51.1% 1.10];P=0.198), nonfatal myocardial infarction (RR, 1.09 [95% CI, 0.63–1.88];P=0.768),

Chest Pain 40

Chest Pain Myocardial Infarction Cardiovascular Imaging Ischemia 40

Dr. Smith's ECG Blog

APRIL 8, 2022

There is a patient with persistent chest pain and an initial troponin I over 52 ng/L; 52 ng/L has an approximate 70% PPV for acute type I MI in a chest pain patient. Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients.

Chest Pain 52

Chest Pain SCAD STEMI Blog 52

Dr. Smith's ECG Blog

MAY 31, 2023

A 67 yo f developed chest pain this morning." Opiates are associated with worse outcomes in Myocardial Infarction. See this case: A man his 50s with chest pain. Association of intravenous morphine use and outcomes in acute coronary syndromes: Results from the CRUSADE Quality Improvement Initiative.

STEMI 96

STEMI Chest Pain Myocardial Infarction Ischemia 96

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. Today’s pain lasted around 20 mins, but was severe enough that the patient called EMS. Triage EKG: What do you think? 1] Wereski, R.,

Chest Pain 52

Chest Pain Ultrasound STEMI Myocardial Infarction 52

DAIC

FEBRUARY 29, 2024

This year’s theme, “Advancing Cardiovascular Care for All” brings the latest practice-changing breakthroughs, along with top experts debating and discussing outcomes of highly-anticipated clinical trials. 24 from April 6 - 8, 2024 in Atlanta, GA at the Georgia World Congress Center.

Aortic valve 103

Aortic valve Myocardial Infarction Aortic Blood Pressure 103

DAIC

MAY 14, 2024

The impact of this narrowing can ultimately result in angina (chest pain), which has been shown to double the risk of major cardiovascular events,1 as well as myocardial infarction ( heart attack ) or even death. Accessed May 2024. Kirtane, Yongjian Wu, William Wijns, Weixian Yang, Martin B. Leon, Shubin Qiao, Gregg W.

Coronary Artery Disease 111

Coronary Artery Disease Interventional Cardiology Innovation Physiology 111

Dr. Smith's ECG Blog

MARCH 10, 2017

A 61 year-old with chest pain arrived to the ED by ambulance with resolving chest pain. The chest pain is resolving, so if these are resolving hyperacute T-waves, then followup ECGs should show their size diminishing. Been discharged to home with potential disastrous outcome. This ECG is NOT normal.

STEMI 52

STEMI Chest Pain Myocardial Infarction Electrocardiogram 52

Dr. Smith's ECG Blog

JULY 11, 2024

Case A 43 year old male with a history of DM II, hyperlipidemia, and a family history of myocardial infarction presented to a family clinic with two days of epigastric pain that started after consuming a meal. He described the pain as a “crushing and discomforting” feeling with no radiation.

Outcomes 113

Outcomes Stenosis Outpatient Echocardiogram 113

Open Heart

JANUARY 30, 2024

Background Patients who experience in-hospital ST-segment elevation myocardial infarction (iSTEMI) represent a uniquely high-risk cohort owing to delays in diagnosis, prolonged time to reperfusion and increased mortality. Key metrics and clinical outcomes were compared before and after CSP implementation.

STEMI 52

STEMI Hospital Chest Pain Outcomes 52

Dr. Smith's ECG Blog

MARCH 9, 2013

This male in his 40's had been having intermittent chest pain for one week. He awoke from sleep with crushing central chest pain and called ems. EMS recorded a 12-lead, then gave 2 sublingual nitros with complete relief of pain. Type B waves are deeper and symmetric. Wellen's syndrome is a Reperfusion syndrome.

Chest Pain 52

Chest Pain Myocardial Infarction Ischemia Angina 52

Dr. Smith's ECG Blog

JUNE 27, 2021

A 50-something man with history only of alcohol abuse and hypertension (not on meds) presented with sudden left chest pain, sharp, radiating down left arm, cramping, that waxes and wanes but never goes completely away. Angiogram: "ACS - Non ST Elevation Myocardial Infarction. This is a HUGE myocardial infarction.

Myocardial Infarction 40

Myocardial Infarction Ischemia STEMI Pulmonary 40