Chest Pain Myocardial Infarction STEMI 
Dr. Smith's ECG Blog
SEPTEMBER 26, 2023
2 middle aged males presented with chest pain. Which had the more severe chest pain at the time of the ECG? Patient 2 at the bottom with a very subtle OMI complained of 10/10 chest pain at the time the ECG was recorded. 414 patients were included in the analysis.
Dr. Smith's ECG Blog
MAY 27, 2024
Written by Jesse McLaren, with a very few edits by Smith A 60-year-old presented with chest pain. The ECG did not meet STEMI criteria, and the final cardiology interpretation was “ST and T wave abnormality, consider anterior ischemia”. But STEMI criteria is only 43% sensitive for OMI.[1]
Dr. Smith's ECG Blog
MARCH 31, 2024
The patient was a middle-aged female who had acute chest pain of approximately 6 hours duration. The pain was still active at the time of evaluation. The interventional cardiologist then canceled the activation and returned the patient to the ED without doing an angiogram ("Not a STEMI"). mm STE in the posterior leads.
Dr. Smith's ECG Blog
DECEMBER 11, 2023
Occlusion myocardial infarction is a clinical diagnosis Written by Willy Frick (@Willyhfrick). A woman in her late 70s presented with left arm pain. The arm pain started the day prior when she was at the dentist's office for a root canal. See this case: Persistent Chest Pain, an Elevated Troponin, and a Normal ECG.
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.
Dr. Smith's ECG Blog
SEPTEMBER 1, 2023
A 50-something male had onset of chest pain 1 hour prior to ED arrival. Endorses some associated SOB, but denies back pain, fever, cough, chills, leg swelling, or other new symptoms. It was tested on a large database of known outcomes and was more than twice as senstivity as STEMI criteria and much better than cardiologists.
Dr. Smith's ECG Blog
MARCH 19, 2024
The patient presented to an outside hospital An 80yo female per triage “patient presents with chest pain, also hurts to breathe” PMH: CAD, s/p stent placement, CHF, atrial fibrillation, pacemaker (placed 1 month earlier), LBBB. HPI: Abrupt onset of substernal chest pain associated with nausea/vomiting 30 min PTA.
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