article thumbnail

ECG Blog #448 — A Young Man with Chest Pain.

Ken Grauer, MD

For example, considering whatever symptoms that the patient may have had ( ie, chest pain, palpitations, shortness of breath, etc. ) — what this might mean in view of the ECG we are looking at. To quote Dr. Stephen Smith: "The worst risk factor for a bad outcome in acute MI is young age."

article thumbnail

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. This case report describes an atypical presentation of CAS in a 68-year-old white British male with cardiovascular risk factors.

article thumbnail

A man in his 40s with 3 days of stuttering chest pain

Dr. Smith's ECG Blog

Written by Willy Frick A man in his early 40s with BMI 36, hypertension, and a 30 pack-year smoking history presented with three days of chest pain. He described it as a mild intensity, nagging pain on the right side of his chest with nausea and dyspnea. It started while he was at rest after finishing a workout.

article thumbnail

A 29 year old male with chest pain, ST Elevation, and very elevated troponin T

Dr. Smith's ECG Blog

By Magnus Nossen This ECG is from a young man with no risk factors for CAD, he presented with chest pain. The patient is a young adult male with chest pain. The chest pain was described as pressure like and radiation to both arms and the jaw. How would you assess this ECG?

article thumbnail

Healthy 45-year-old with chest pain: early repolarization, pericarditis or injury?

Dr. Smith's ECG Blog

A healthy 45-year-old female presented with chest pain, with normal vitals. The patient was previously healthy, with no atherosclerotic risk factors, and developed chest pain after an episode of stress. The pain was crushing retrosternal, radiated to the arms and was associated with lightheadedness.

article thumbnail

Ep 128 Low Risk Chest Pain and High Sensitivity Troponin – A Paradigm Shift

ECG Cases

What are the most useful historical factors to increase and decrease your pretest probability for ACS? Which cardiac risk factors have predictive value for ACS? The post Ep 128 Low Risk Chest Pain and High Sensitivity Troponin – A Paradigm Shift appeared first on Emergency Medicine Cases.

article thumbnail

A 20-something with intermittent then acute chest pain

Dr. Smith's ECG Blog

Healthy male under 25 years old with a pretty good story for acute onset crushing chest pain relieved with nitro. Aggressive risk factor modification. PEARL: Most patients who present with new chest pain + ECG changes + positive troponin — will not need Cardiac MRI. No pericardial effusion on ultrasound."