Dr. Smith's ECG Blog

MAY 20, 2024

A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon. He called EMS, who arrived on scene about two hours after the onset of pain to find him hypertensive at 220 systolic.

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Chest Pain Blood Pressure Ischemia STEMI 125

MIBHS

FEBRUARY 15, 2025

This condition reduces blood flow to the heart, increasing the risk of angina (chest pain) and heart attacks. Coronary Artery Disease (CAD) : High blood pressure accelerates the development of CAD by promoting the buildup of plaques in the coronary arteries.

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Blood Pressure Hypertension Chest Pain Aneurysm 52

The British Journal of Cardiology

MARCH 7, 2024

The National Institute for Health and Care Excellence (NICE) advise against routine testing for coronary artery disease (CAD) in patients with non-anginal chest pain (NACP). Cardiovascular risk factors were compared between the groups. Over 23 months, 866 patients with NACP underwent CTCA. We found 11.5%

Coronary Artery Disease 40

Coronary Artery Disease Chest Pain Risk Factors Hypertension 40

Dr. Smith's ECG Blog

APRIL 9, 2023

Submitted by Ali Khan MD and James Mantas MD, MS, written by Pendell Meyers A man in his 50s with history of diabetes, hypertension, and tobacco use presented to the ED with 24 hours of worsening left sided chest pain radiating to the back, characterized as squeezing and pinching, associated with shortness of breath.

Chest Pain 52

Chest Pain Ischemia Stenosis Pulmonary 52

Open Heart

NOVEMBER 27, 2023

Objective Prehospital rule-out of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in low-risk patient with a point-of-care troponin measurement reduces healthcare costs with similar safety to standard transfer to the hospital. Low-risk patients (HEAR score ≤3) were included.

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Chest Pain Risk Factors Hospital 52

Dr. Smith's ECG Blog

JULY 31, 2013

A 20-something male presented from an outside facility with Chest pain. No thromboembolism risks, not pleuritic, no radiation to the back. No cardiac risk factors, no cocaine use. Vital signs were normal. History: Onset of CP 2.5 hours prior to ED arrival. Tight and pressure, radiates to right arm, + nausea, + SOB.

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Chest Pain Aneurysm STEMI Ischemia 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionPatients with cognitive impairment often have a history of cardiovascular disease (CVD) or multiple cardiovascular risk factors (CRFs) such as hypertension, obesity, and hypercholesterolemia. The literature reports that CVD with CRFs may increase the risk of developing vascular dementia and Alzheimer’s Disease.

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Risk Factors Dementia Chest Pain Quality of Life 40

Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

On the second morning of his admission, he developed 10/10 chest pain and some diaphoresis after breakfast. The patient was given opiates which improved his chest pain to 7/10. The consulting cardiologist wrote in their note: “Could be cardiac chest pain. She is usually incredibly good at recognizing them!

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Chest Pain Blog Hospital Tachycardia 120

CTVS

JANUARY 25, 2024

Because its symptoms are commonly associated with so many other conditions, like a cough and chest pain, lung cancer can be hard to diagnose. At CTVS, we are proponents of early screening for lung cancer, especially if you have certain risk factors such as… Source

Cancer 40

Cancer Chest Pain Risk Factors 40

Frontiers in Cardiovascular Medicine

OCTOBER 10, 2024

Genetic protein S (PS) deficiency caused by PROS1 gene mutation is an important risk factor for hereditary thrombophilia.Case introductionIn this case, we report a 28-year-old male patient who developed a severe pulmonary embolism during his visit. The patient had experienced one month of chest pains, coughing and hemoptysis symptoms.

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Embolism Pulmonary Chest Pain Thrombosis 40

Dr. Smith's ECG Blog

JULY 3, 2018

Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. The pain initially started the day prior to presentation. The ST elevation from today is ~0.2

Pericarditis 52

Pericarditis Chest Pain Stents Stent 52

Journal of the American Heart Association

MARCH 27, 2025

years]) admitted to the China Chest Pain Center Database between 2016 and 2021. Hierarchical clustering of 15 medical conditions was performed to derive multimorbidity patterns. The primary outcome was a composite of inhospital adverse events.

Myocardial Infarction 40

Myocardial Infarction Peripheral Arterial Disease Outcomes Chest Pain 40

Heart BMJ

JANUARY 29, 2024

Likelihood of CAD can be estimated based on symptoms and risk factors, and an abnormal ECG may also be helpful. Patients with moderate/high probability of CAD are usually referred for further tests including angiography (CT or invasive) or isotope-based myocardial perfusion scans.

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Exercise Chest Pain Coronary Artery Disease Angina 40

AMS Cardiology

AUGUST 15, 2023

Understanding the risk factors, recognizing the signs and seeking guidance from a cardiologist can play a significant role in preventing and treating this disease. Identifying Those at Risk for Heart Disease Heart disease describes a range of disorders that affect the cardiovascular system and the heart.

Heart Disease 52

Heart Disease Blood Pressure Risk Factors Cholesterol 52

Dr. Smith's ECG Blog

DECEMBER 13, 2019

Written by Pendell Meyers A man in his late 40s with several ACS risk factors presented with a chief complaint of chest pain. Several hours prior to presentation, while driving his truck, he started experiencing new central chest pain, without radiation, aggravating/alleviating factors, or other associated symptoms.

Pericarditis 52

Pericarditis Chest Pain Aortic Blog 52

MIBHS

JULY 31, 2024

Unhealthy Coping Mechanisms When under constant stress, many people turn to unhealthy coping mechanisms like overeating, smoking, or excessive alcohol consumption – habits that can further exacerbate cardiovascular issues by contributing to obesity, high blood pressure, and other risk factors.

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Blood Pressure Heart Attack Heart attacks Heart Rhythm 52

Dr. Smith's ECG Blog

AUGUST 26, 2019

She did not report any chest pain or pressure. She was brought to the Emergency Department and this ECG was recorded while she was still feeling nauseous but denied chest pain, shortness of breath, or other symptoms: What do you think? A male in his 60s with chest pain A Male in his 60s with Chest pain.

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Chest Pain STEMI Biomarkers Article 52

MIBHS

JUNE 28, 2024

Minimize your intake of processed foods, sugary snacks, and foods high in saturated and trans fats, as these can contribute to heart disease risk factors such as high cholesterol and hypertension. By reducing stress levels, you can lower your risk of heart disease and improve overall cardiac health.

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Blood Pressure Diet Heart Disease Cholesterol 52

Dr. Smith's ECG Blog

SEPTEMBER 6, 2011

A 39 yo otherwise healthy man with no risk factors was walking at the mall when he developed chest pressure. However, if you notice the ST depression, you then realize that this is ischemic chest pain, not esophageal spasm. He presented to the ED after 30 minutes, now also feeling weak. He was diaphoretic.

Chest Pain 52

Chest Pain Ischemia STEMI Stents 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Risk factors such as smoking, chronic kidney disease, and aging can contribute to plaque formation. The gradual loss of elasticity in arterial walls and the presence of other risk factors, such as high blood pressure and diabetes, contribute to the increased risk of cardiovascular disease (CVD) observed in aging populations.

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Risk Factors Blood Pressure Chest Pain Plaque 40

Dr. Smith's ECG Blog

APRIL 20, 2018

female with HTN, HLD, diabetes, ESRD on dialysis is brought in by EMS with sudden onset, left -sided chest pain for the past four hours. While she was in her bed at home, she had sudden onset of left sided chest pain that radiated to her shoulder. The pain was pleuritic, without nausea or diaphoresis.

Chest Pain 40

Chest Pain Ultrasound Risk Factors STEMI 40

All About Cardiovascular System and Disorders

MAY 1, 2024

Important risk factors for diseases of blood vessels are high blood pressure and sugar, high blood fat levels, overweight/obesity, and smoking. Advancing age, heredity and male gender are also risk factors for diseases of blood vessels. Blood seeps into the wall of the aorta and spreads along the wall of the aorta.

Blood Pressure 40

Blood Pressure Risk Factors Chest Pain Heart Attack 40

Ken Grauer, MD

FEBRUARY 3, 2024

As discussed in detail in ECG Blog #228 — this seemingly qualifies as a “ Silent ” MI ( Approximately half of those MIs not accompanied by CP — have some other associated symptom such as syncope, which substitutes as a “chest pain equivalent” ). Longterm prognosis of patients with MINOCA clearly depends on the underlying etiology.

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Blog Cardiac Arrest STEMI Plaque 162

Dr. Smith's ECG Blog

NOVEMBER 17, 2014

This case was recently posted by Tyron Maartens on Facebook EKG club (he agreed to let me post it here), with the following clinical information: "42 year old male with two weeks of intermittent chest discomfort, awoke 4 hours prior to this ECG with a more severe, heavy chest pain (5/10). BP 112/80, SpO2 100%.

Aneurysm 52

Aneurysm STEMI Chest Pain Risk Factors 52

Dr. Smith's ECG Blog

AUGUST 15, 2019

Written by Pendell Meyers A male in his early 50s presented with waxing and waning chest pain starting at rest. He had multiple cardiovascular risk factors and the EM physician strongly suspected ACS. Here is his initial ECG: What do you think? mm of the "required" 1.0

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STEMI Chest Pain Risk Factors Anatomy 52

Dr. Smith's ECG Blog

JANUARY 1, 2013

A middle aged male with no h/o CAD presented with one week of crescendo exertional angina, and had chest pain at the time of the first ECG: Here is the patient's previous ECG: Here is the patient's presenting ED ECG: There is isolated ST depression in precordial leads, deeper in V2 - V4 than in V5 or V6. There is no ST elevation.

STEMI 52

STEMI Ischemia Chest Pain Myocardial Infarction 52

Dr. Smith's ECG Blog

FEBRUARY 14, 2020

Meyers and Smith, who instantly recognized impending LAD occlusion Although I completely agreed on the need for prompt cardiac cath in this 50s man with risk factors and new symptoms — I did not initially recognize the “culprit artery”. Sometimes serial ECGs minimizes the delay. Sometimes serial ECGs minimizes the delay. CREDIT to Drs.

Chest Pain 52

Chest Pain STEMI Anatomy Risk Factors 52

Dr. Sanjay Gupta

DECEMBER 19, 2022

She asked me why I felt she had had a heart attack and I explained to her that she had had chest pains and the blood test indicating damage to the heart was elevated and that was all we needed to say that she had had a heart attack. Genetics and physiological stress are also risk factors.

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Heart Attack Heart attacks Blood Clot Chest Pain 40

DAIC

DECEMBER 8, 2023

AFib causes a variety of symptoms, including fast or chaotic heartbeat, fatigue, shortness of breath, and chest pain, and causes about 450,000 hospitalizations each year, according to the Centers for Disease Control and Prevention. For example, kidney disease is not included in CHA 2 DS 2 -VASc.

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Atrial Fibrillation AFIB Strokes Stroke 52

Dr. Smith's ECG Blog

APRIL 2, 2014

A male in his 60's called 911 for chest pain. He had some cardiac risk factors including hypertension, on meds, but no previous coronary disease. His pain was intermittent and he was vague about when it was present and when it was resolved. Here is his prehospital ECG: Diagnosis?

STEMI 52

STEMI Ischemia Chest Pain Angioplasty 52

All About Cardiovascular System and Disorders

JULY 21, 2024

As age advances and depending on risk factors like heredity, smoking, high blood pressure and diabetes, fat build up occurs in these blood vessels. This can block smooth flow of blood and the person can develop chest pain. Coronary arteries are blood vessels supplying oxygenated blood to the heart.

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Coronary Artery Bypass Graft Angioplasty Cardiac Rehabilitation Chest Pain 40

Dr. Smith's ECG Blog

OCTOBER 8, 2018

"I have enclosed the ECG from a 50-something year old male who complained of chest pain. He had no further risk factors for atherosclerosis besides hypertension. For clarity — I’ve labeled the compressed 12-lead tracing of this 50-ish year old man with new chest pain ( Figure-1 ).

STEMI 52

STEMI Chest Pain Blog Atherosclerosis 52

Dr. Smith's ECG Blog

JUNE 20, 2018

A 40 something woman with a history of hyperlipidemia and additional risk factors including a smoking history presented with substernal chest pain radiating to "both axilla" as well as the upper back. She was reportedly "pacing in her room while holding her chest". The source of this case is anonymous.

Pericarditis 52

Pericarditis Chest Pain Blog Ultrasound 52

Dr. Smith's ECG Blog

JULY 31, 2018

hours of substernal chest pressure. She had zero CAD risk factors. SCAD occurs in patients with few or non-traditional cardiovascular risk factors. The patient profile in this case is deceptive = a seemingly healthy, athletic and very fit 30-year woman with no risk factors and no significant prior medical history.

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SCAD Chest Pain Myocardial Infarction Ischemia 52

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

A 70-something female with no previous cardiac history presented with acute chest pain. She awoke from sleep last night around 4:45 AM (3 hours prior to arrival) with pain that originated in her mid back. She stated the pain was achy/crampy. Over the course of the next hour, this pain turned into a pressure in her chest.

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Coronary Angiogram Plaque Thrombosis STEMI 109

DAIC

FEBRUARY 29, 2024

ET Murphy Ballroom 4 Health 360x Registry: Scalable Workforce for Equitable Access to Point of Care Decentralized Clinical Trials Prevalence of Cardiovascular Disease and Risk Factors Among National Football League Alumni and Their Family Members: Results from the Huddle Study Hózhó (Heart Failure Optimization at Home to Improve Outcomes): A Pragmatic (..)

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Aortic valve Myocardial Infarction Aortic Blood Pressure 103

Dr. Smith's ECG Blog

DECEMBER 15, 2023

The patient contacted EMS after a few hours of chest pain that started 5:30 AM. The pain was described as 6/10 radiating to the right shoulder. The chest pain was described as both sharp and pressure like. There is slight ST depression in lateral chest leads V4,V5,V6 — but I thought this to be nonspecific.

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Chest Pain Blog Ischemia Risk Factors 60