Chest Pain and Outpatient - Cardiovascular Update

A man in his 40s with acute chest pain. What do you think?

Dr. Smith's ECG Blog

SEPTEMBER 29, 2023

Sent by anonymous, written by Pendell Meyers, reviewed by Smith and Grauer A man in his 40s presented to the ED with HTN, DM, and smoking history for evaluation of acute chest pain. He was eating lunch when he had sudden onset chest pressure, 9/10, radiating to his back, with sweating and numbness in both hands. was discovered.

Chest Pain

Chest Pain Tachycardia STEMI Blog

Siemens Healthineers Announces FDA Clearance of Somatom Pro.Pulse Dual-Source CT Scanner

DAIC

DECEMBER 19, 2023

milla1cf Tue, 12/19/2023 - 17:05 December 19, 2023 — Siemens Healthineers announced the Food and Drug Administration ( FDA ) clearance of the Somatom Pro.Pulse, a dual-source computed tomography scanner designed to be more affordable for a wide range of healthcare facilities, including outpatient diagnostic centers. Mukherjee, D.,

Chest Pain

Chest Pain Coronary Artery Disease Technology Outpatient

An adolescent with trauma, chest pain, and a wide complex rhythm

Dr. Smith's ECG Blog

JUNE 14, 2017

There was apparently no syncope and he had no bony injuries, but he did complain of left sided chest pain. His chest was tender. He was discharged and schedule for an outpatient echo which has not been done yet. A bedside cardiac ultrasound was normal. An ECG was recorded: Avinash was understandably confused by this ECG.

Chest Pain

Chest Pain Congenital Heart Disease Article Congenital

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

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Hackensack Meridian Jersey Shore University Medical Center Providing State-of-the-Art Medtronic APOLLO Clinical Trial Treating Heart Valve Disease

DAIC

FEBRUARY 20, 2024

Monmouth and Ocean county residents are becoming increasingly aware of the world-class cardiovascular care provided at Jersey Shore.

Heart Valves

Heart Valves Bicuspid/Mitral Academic Chest Pain

A Picture of Subendocardial Ischemia

Dr. Smith's ECG Blog

MAY 23, 2014

This patient presented with a mechanical fall and had chest pain. His chest pain increased and this ECG was recorded: Now there is increasing inferior ST elevation. Severe Left Main disease, and chest pain with contrast injection into the LM. This case shows a CT image of subendocardial ischemia.

Ischemia

Ischemia Chest Pain STEMI Outpatient

See how bad the outcome can be if you don't know OMI findings on the ECG, and don't use the Queen of Hearts

Dr. Smith's ECG Blog

JULY 11, 2024

No patient with chest pain should be sent home without troponin testing. BOTTOM Line: Unless primary care clinicians attain a level of excellence in the interpretation of outpatient X-rays and ECGs — these tests should be routinely overread by physicians with recognized expertise in this interpretation.

Outcomes

Outcomes Stenosis Outpatient Echocardiogram

Who Needs a CT Coronary Angiogram?

All About Cardiovascular System and Disorders

APRIL 17, 2024

CT coronary angiogram can be done as an outpatient test, in the X-ray department. CT coronary angiogram is useful to rule out significant blocks in in those presenting with chest pain to the emergency department. Veins are blood vessels returning deoxygenated blood to the heart.

Coronary Angiogram

Coronary Angiogram Catheterization Laboratory Angioplasty Chest Pain

A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Hopefully a repeat echocardiogram will be performed outpatient. 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. 1900: RBBB and LAFB are almost fully resolved.

Tachycardia

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia

85 year old with chest pain, STEMI negative, then normal troponin but with relatively large delta: discharge?

Dr. Smith's ECG Blog

MARCH 24, 2023

Written by Jesse McLaren, with comments from Smith An 85 year old with a history of CAD presented with 3 hours of chest pain that feels like heartburn but that radiates to the left arm. See this other post: Chest pain, a ‘normal ECG’ a ‘normal trop’, and low HEART and EDACS score: discharge home? Below is the ECG.

Chest Pain

Chest Pain STEMI Bradycardia Ischemia

The Evolving Computed Tomography Market

DAIC

MARCH 7, 2024

It reported the rate of CCTA exams by radiologists in hospital outpatient departments increased markedly from 2010 to 2019. Over that period, the rates of CCTA by radiologists in hospital outpatient departments increased by 355%, according to findings of Russell A. Reeves, MD, Ethan J. Halpern, MD, and Vijay M.

Technology

Technology Document Cardiovascular Imaging Cancer

Embracing Cardiac Imaging: Overcoming Barriers, Adopting In-house Solutions, and Navigating Future Advancements

DAIC

MARCH 20, 2024

Cardiac CT scans, recommended by the American College of Cardiology (ACC) and the American Heart Association (AHA) as the primary testing strategy for patients with acute chest pain, are necessary for evaluating cases and determining treatment plans. Despite its importance, a substantial number of U.S.

Technology

Technology Coronary Artery Disease Patient Care Private Practice

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

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. Chest pain, SOB, Precordial T-wave inversions, and positive troponin. What is the Diagnosis? Now another, with ultrasound.

Cardiac Arrest

Cardiac Arrest Chest Pain Embolism Pulmonary

See OMI vs. STEMI philosophy in action

Dr. Smith's ECG Blog

DECEMBER 22, 2022

His medical history is unremarkable except a similar pain occurred 4-5 times in the previous 3 months with less intensity, short duration, unrelated to exertion. He visited an outpatient clinic for it and an echocardiogram and exercise stress test was normal. He has 40 packs-year of smoking history.

STEMI

STEMI Chest Pain Myocardial Infarction Electrocardiogram

A COVID19 vaccine exemption letter

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. It is relevant to note here that as a physician active clinically in both the inpatient and outpatient arenas, I am an eyewitness to the severe toll COVID19 took on my patients in the Spring or 2020.

COVID-19

COVID-19 Pericarditis Chest Pain Public Health

Syncope, chest pain, and inferior ST Elevation with Reciprocal ST depression in aVL

Dr. Smith's ECG Blog

JANUARY 9, 2025

A 26 year old male presented with syncope and chest pain. No signs of OMI" The chest pain resolved after some time, and another ECG was recorded: The ST Elevation is nearly gone. Syncope was sudden and without prodrome, and resulted in head trauma with a scalp laceration. Smith : I recognize this as a STEMI mimic.

Chest Pain

Chest Pain Ischemia Dysrhythmia Arrhythmia

Effectiveness of rapid access chest pain clinics: a systematic review of patient outcomes and resource utilisation

Heart BMJ

NOVEMBER 25, 2024

Background Rapid Access Chest Pain Clinics (RACPC) are widely used for the outpatient assessment of chest pain, but there appears to be limited high-quality evidence justifying this model of care. This study aimed to review the literature to determine the effectiveness of RACPCs.

Chest Pain

Chest Pain Outcomes Outpatient

Trust the coronaries : There are benign forms of ACS too !

Dr. S. Venkatesan MD

JANUARY 22, 2025

I don’t understand how the curve of non-cardiac chest pain trespasses in the middle of a Troponin race (False positives? Many low-risk categories can be managed as outpatients; it is still true. High sensitivity Troponin (hsTnT) do play a useful role in identifying low risk UA/NSTEMI , as seen in the following study.

Coronary Angiogram

Coronary Angiogram Chest Pain Anatomy Angina

A man in his 40s with acute chest pain. What do you think?

Siemens Healthineers Announces FDA Clearance of Somatom Pro.Pulse Dual-Source CT Scanner

An adolescent with trauma, chest pain, and a wide complex rhythm

Webinars

Hackensack Meridian Jersey Shore University Medical Center Providing State-of-the-Art Medtronic APOLLO Clinical Trial Treating Heart Valve Disease

A Picture of Subendocardial Ischemia

See how bad the outcome can be if you don't know OMI findings on the ECG, and don't use the Queen of Hearts

Who Needs a CT Coronary Angiogram?

A teenager involved in a motor vehicle collision with abnormal ECG

85 year old with chest pain, STEMI negative, then normal troponin but with relatively large delta: discharge?

The Evolving Computed Tomography Market

Embracing Cardiac Imaging: Overcoming Barriers, Adopting In-house Solutions, and Navigating Future Advancements

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

See OMI vs. STEMI philosophy in action

A COVID19 vaccine exemption letter

Syncope, chest pain, and inferior ST Elevation with Reciprocal ST depression in aVL

Effectiveness of rapid access chest pain clinics: a systematic review of patient outcomes and resource utilisation

Trust the coronaries : There are benign forms of ACS too !

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