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Four patients with chest pain and ‘normal’ ECG: can you trust the computer interpretation?

Dr. Smith's ECG Blog

Written by Jesse McLaren Four patients presented with chest pain. If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation?

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LBBB: Using the (Smith) Modified Sgarbossa Criteria would have saved this man's life

Dr. Smith's ECG Blog

Jesse McLaren (@ECGcases), of Emergency Medicine Cases Reviewed by Pendell Meyers and Steve Smith An 85yo with a history of hypertension developed chest pain and collapsed, and had bystander CPR. The paramedics found the patient with ROSC and a GCS 7, and an ECG showing LBBB with possible lateral ST elevation. Learning points 1.

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CMS Updates Medicare Coverage for AI-Coronary Plaque Analysis

DAIC

This is a positive step towards improved patient care,” said Ahmad Slim, MD, FSCCT, director of imaging at Pulse Heart Institute and chair of the HPPC.

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Slightly Peaked T-waves. What is it?

Dr. Smith's ECG Blog

The above is what I thought when I saw this, so I went to the chart and found this history: A type I diabetic aged approximately 35 years old presented with chest pain, nausea, vomiting and diffuse abdominal pain. The patient was in DKA with an anion gap of 35, a glucose of 1128, and a K of 5.5 It was stented.

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American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

DAIC

24 and how those may impact clinical practice and patient care in this deep dive clinical trial session. ET Murphy Ballroom 4 ACC.24 24 planners note that attendees can gain insights from key clinical trials presented at ACC.24 More information: www.acc.org If you enjoy this content, please share it with a colleague

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OMI can be very subtle and easy to miss, but be a very large infarction.

Dr. Smith's ECG Blog

Even if you don't see the OMI, you can usually prevent such a long delay to reperfusion by recording serial ECGs every 15 minutes for a patient with persistent chest pain. Record serial ECGs every 15 minutes!! Hillinger et al. If not — Do you think this would be helpful? The rhythm in ECG #1 is sinus bradycardia and arrhythmia.

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How much time are you willing to wait for OMI to become STEMI (if it ever does)?

Dr. Smith's ECG Blog

Written by Pendell Meyers, few edits by Smith A man in his 60s with history of stroke and hypertension but no known heart disease presented with chest pain that started on the morning of presentation at around 8am. Here is his triage ECG when he presented at 1657: What do you think? There, one sees typical STEMI to one's satisfaction.

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