Dr. Smith's ECG Blog
JUNE 5, 2023
A 40-something male presented by ambulance with one hour of chest pain that was improving after sublingual nitroglycerine and 325 mg of aspirin, chewed. Here is his initial ED ECG: What do you think? This is because IF the history is recent CP — then this initial ED ECG has to be interpreted like Drs.
Dr. Smith's ECG Blog
FEBRUARY 6, 2023
Sent by anonymous, written by Pendell Meyers A man in his 60s presented with acute chest pain with diaphoresis. The Importance of the History: As noted above — the onset of chest pain in today's case was acute. He had received aspirin and nitroglycerin by EMS, with some improvement. His vitals were within normal limits.
Dr. Smith's ECG Blog
JANUARY 17, 2023
A 60 year old with chest pain presented to the ED. In this case, lead I does not look bizarre, but all other leads do. == N OTE : The reasons I especially liked today's case are: i ) The patient presented with chest pain — so the importance of distinguishing artifact from reality can not be overstated! —
Dr. Smith's ECG Blog
SEPTEMBER 27, 2019
An elderly woman presented with chest pain that radiated to the back for several hours. The first troponin returned at 0.099 ng/mL (elevated, consistent with Non-Occlusion MI) Providers were concerned with aortic dissection, so they order a chest aorta CT. Here is here initial ECG: There is only a nonspecific flat T-wave in aVL.
Dr. Smith's ECG Blog
OCTOBER 13, 2022
Written by Jesse McLaren, with edits from Smith and Grauer A 60 year old with no past medical history presented with two hours of chest pain radiating to the left arm, with normal vitals. Unfortunately, the reality is — that many ( most ) WPW patients who present with chest pain do not manifest intermittent preexcitation.
Open Heart
MAY 2, 2023
Availability of systematic coronary physiology might result in more homogeneous interpretation and management strategy compared with ICA alone. Methods 150 coronary angiograms from patients with stable chest pain were presented independently to three NICs, three ICs and three CSs. Trial registration number NCT01070771.
Dr. Smith's ECG Blog
MARCH 15, 2021
An 80-something year old man with history of metastatic cancer had acute onset of chest pain and called 911. There is no typical evolution of MI (so BOTH EKG evolution, and troponin, proves there was no acute MI) 2 weeks later, the patient present with acute chest pain again. He ruled out for MI by troponins again.
Expert insights. Personalized for you.
96 
Let's personalize your content