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Critical Left Main

EMS 12-Lead

David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (ret) @DidlakeDW Expert commentary and peer review by Dr. Steve Smith [link] @smithECGBlog A 57 y/o Female with PMHx HTN, HLD, DM, and current use of tobacco products, presented to the ED with chest discomfort. What’s interesting is that the ECG can only detect ischemia.

Angina 52
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Dark Side of the Moon

EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review by Dr. Stephen Smith @smithECGblog I was reviewing ECG’s in our LifeNet database and happened upon this one without any knowledge of clinical circumstances. Cardiology admitted him for observation with plans for next-day coronary angiogram.

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Hypertrophic Cardiomyopathy

EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review and commentary by Dr. Steve Smith [link] @SmithECGblog It is early-summer, approximately 1330 hours, no cloud cover overhead, and 86 degrees with high humidity. There is LBBB-like morphology with persistent patterns of subendocardial ischemia.

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A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

This case reminds me of this 27 year old totally healthy nurse who was previously healthy, presented with acute pulmonary edema and the below ECG that is diagnostic of proximal LAD occlusion, and was dismissed because of her age. This gets drilled into them.