Remove Chest Pain Remove Plaque Remove Tachycardia
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Recurrent polymorphic ventricular tachycardia without chest pain: an unusual presentation of focal coronary artery spasm

The British Journal of Cardiology

Coronary artery spasm (CAS), or Prinzmetal angina, is a recognised cause of myocardial ischaemia in non-obstructed coronary arteries which typically presents with anginal chest pain. The patient presented with recurrent palpitations and pre-syncope, with no chest pain.

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Explain this ECG in the context of active chest pain, slightly elevated troponin without a delta, RCA culprit, and previous with LBBB

Dr. Smith's ECG Blog

A 60-something yo female presented w/ exertional chest pain for 3 days. Pain was 8/10 and constant. She has been experiencing progressively worsening exertional dyspnea and chest tightness mostly when climbing up flights of stairs since early September. But the patient has active chest pain.

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Anaphylaxis, chest pain, and ST elevation in aVR

Dr. Smith's ECG Blog

Shortly after receiving epinephrine, the patient developed new leg cramps and chest pain. The chest pain was described as sharp and radiated to both arms. During active chest pain an ECG was recorded: Meyers ECG interpretation: Sinus tachycardia, normal QRS complex, STD in V2-V6, I, II, III and aVF.

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60-something with wide complex tachycardia: from where does the rhythm originate?

Dr. Smith's ECG Blog

Here is her ED ECG: Here is the ED physician's interpretation: IMPRESSION UNCERTAIN REGULAR RHYTHM, wide complex tachycardia, likely p-waves. LEFT BUNDLE BRANCH BLOCK [120+ ms QRS DURATION, 80+ ms Q/S IN V1/V2, 85+ ms R IN I/aVL/V5/V6] Comparison Summary: LBBB and tachycardia are new. This is clearly ventricular tachycardia.

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Elder Male with Syncope

EMS 12-Lead

There was no chest pain. V1 and V2 are probably placed too high on the chest given close morphological similarity to aVR. Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates). The fall was not a mechanical etiology. Type I ischemia.

Ischemia 116
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A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day

Dr. Smith's ECG Blog

A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chest pain and SOB. She had one episode of pain the previous night and two additional episodes early on morning the morning she presented. Deep breaths are painful and symptoms come and go.

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Critical Left Main

EMS 12-Lead

But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chest pain was a little more intense, and the needed recovery period was longer in duration. Severe Tachycardia Acute Coronary Syndrome (obstructive coronary disease) a. This results in Type I MI.

Angina 52