Remove Echocardiogram Remove ICU Remove STEMI
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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

for those of you who do not do Emergency Medicine, ECGs are handed to us without any clinical context) The ECG was read simply as "No STEMI." Echocardiogram showed severe RV dilation with McConnell’s sign and an elevated RVSP. The patient was upgraded to the ICU for closer monitoring.

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OMI Can be Diagnosed by "Pseudonormalization of ST Segments"

Dr. Smith's ECG Blog

This appears to be new, as her last formal echocardiogram 2 years ago was relatively normal. I took part in her ICU care and she was extubated and stable to transfer to a stepdown unit after a few days. Patients like her are the reason we are advocating for a change in the ACS paradigm from STEMI to OMI.

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"Pericarditis" strikes again

Dr. Smith's ECG Blog

The next morning the patient went for his routine echocardiogram, where the operator noticed a dilated aortic root at 5.47 in the ICU but survived with excellent function. normal variant, not pericarditis) A Young Man with Sharp Chest pain (normal variant, not pericarditis) 24 yo woman with chest pain: Is this STEMI?

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A dialysis patient with nonspecific symptoms and pseudonormalization of ST segments

Dr. Smith's ECG Blog

I think a good start would be a posterior EKG and a high quality contrast echocardiogram read by an expert. Fortunately, he was extubated several days later in the ICU with intact baseline mental status and was discharged shortly thereafter to subacute rehab. His prior EF from an ECHO 6 months prior indicated 35% LVEF.