Chest Pain Nursing STEMI 
Dr. Smith's ECG Blog
MARCH 27, 2025
Theres ST elevation in V3-4 which meets STEMI criteria, which could be present in either early repolarization, pericarditis or injury. Lets see what happens in the current STEMI paradigm. Emergency physician: STEMI neg but with elevated troponin = Non-STEMI The first ECG was signed off. Chest pain still persists.
Dr. Smith's ECG Blog
OCTOBER 24, 2019
[link] A 30 year-old woman was brought to the ED with chest pain. It had started just after nursing her newborn, about an hour prior, and she described it as a severe non-pleuritic “pressure” radiating to the back. She had given birth a week ago, and she had similar chest pain during her labor. Lobo et al.
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. 50% of LAD STEMIs do not have reciprocal findings in inferior leads, and many LAD OMIs instead have STE and/or HATWs in inferior leads instead. Pericarditis?
Dr. Smith's ECG Blog
DECEMBER 23, 2014
The patient was diagnosed with esophageal reflux and was being discharged by the nurse when he had a cardiac arrest. Anterolateral STEMI. The formula results in 23.43, just above the 23.4 He was defibrillated. Here is his post resuscitation ECG: Now the diagnosis is obvious.
Dr. Smith's ECG Blog
DECEMBER 11, 2023
After dinner the day of presentation, she had left neck and elbow pain which she described as dull, achy, and worse with exertion. She contacted her neighbor, a nurse, for help. See this case: Persistent Chest Pain, an Elevated Troponin, and a Normal ECG. The patient presented to triage at around 10 PM. At midnight.
Open Heart
JANUARY 30, 2024
A comprehensive iSTEMI protocol (CSP) was implemented on 15 July 2014, incorporating: (1) cardiology fellow activation of the catheterisation lab using standardised criteria, (2) nursing chest pain protocol, (3) improved electronic access to electrocardiographic studies, (4) checklist for initial triage and management, (5) 24/7/365 catheterisation (..)
Dr. Smith's ECG Blog
OCTOBER 26, 2011
Echo on the day after admission showed EF of 30-35% and antero-apical wall akinesis with an LV thrombus [these frequently form in complete or near complete (no early reperfusion) anterior STEMI because of akinesis/stasis] 2 more days later, this was recorded: ST elevation is still present. He had been awakened by cough at 3 AM 2 days earlier.
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