dr smith's ecg blog

• Unresponsive and Acidotic: OMI? Acute, subacute, or reperfused? What is the rhythm? Why RV dysfunction? Can CT scan help?
• Will this case be flagged for Quality Improvement in the STEMI/NSTEMI Paradigm?
• What is Wellens' syndrome? And what conditions mimic it?
• Everyone sees ST depression, but what does it mean?
• Even in retrospect, no one could see it.
• Can you localize the culprit lesion on angiogram without taking ECG findings into account?
• When ACS care is very delayed, "STEMI metrics" can be perfect. And how specific is Queen of Hearts?
• Is it possible that this patient with acute chest pain and this ECG does not need emergent intervention?
• Normal ACS care, everything by the book! But normal ACS care could be much better. This post explains everything.
• What happens when you give morphine for chest pain in ACS? And what is pseudo-normalization of T-waves?
• Chest pain and computer ‘normal’ ECG. Wait for troponin? And what is the reference standard for ECG diagnosis? Cardiologist or outcome?
• "Anterior" ST Depression: Which Lesion is the Culprit?
• Patient is informed of her husband's death: is it OMI or it stress cardiomyopathy?
• What is this rhythm? And why rhythm problems are easier for the Emergency Physician than acute coronary occlusion (OMI).
• Pulmonary edema, with tachycardia and OMI on the ECG -- what is going on?
• Pay now (in the evening) or pay later with interest (in the middle of the night).
• Chest pain followed by 6 days of increasing dyspnea -- what happened?
• Acute coma, then Sudden PEA arrest in front of paramedics, with STEMI?
• After seeing this ECG, are there any medications you would consider giving?
• What factor determines final diagnosis of STEMI vs. NSTEMI? Is it ST Elevation? Occlusion? or Something else? What?
• A man in his 30s with epigastric pain and chest pressure
• ** **ACUTE MI/STEMI** **: Activate the cath lab if the patient has chest pain?
• Potassium 6.2 with narrow QRS: any indication for calcium?
• ‘NSTEMI’ or reperfused OMI? And which lesion is the culprit?
• Electrical instability in a healthy 50 year old. How to manage?
• Syncope and a short pause on event monitor
• Sometimes a patient is fortunate to have a cardiac arrest
• Another MUST know ECG, and why its notoriety annoys Dr. Smith
• A 34 yo Man with chest pain and Zero ST Elevation
• Challenging Rhythms in an 80-something Man
• Should we wait for troponin when the ECG does not show "diagnostic" ST Elevation?
• Acute chest pain with LBBB and obvious OMI, worsening on serial ECGs, but repeatedly missed by physicians and Marquette 12SL
• Acute Dyspnea in a Dialysis Patient. K is 6.3 mEq/L. Are ECG findings due to hyperkalemia, or even due to Type 2 MI?
• Abdominal Pain in a middle-aged patient
• New Review Article in Annals of Emergency Medicine: ECG Patterns of Occlusion Myocardial Infarction: A Narrative Review
• Normal ECG by many measures. Is it normal?
• A 50-something man with Chest pain at triage
• Online QTc Calculator for normal and wide QRS (LBBB, RBBB, etc.)
• One of those ECGs you need to instantly recognize, which learners may struggle with at first
• Syncope, chest pain, and inferior ST Elevation with Reciprocal ST depression in aVL
• Is it important to try to determine the culprit vessel based on ECG?
• Torsade in a patient with left bundle branch block: is there a long QT? (And: Left Bundle Pacing).
• OMI? Subendocardial ischemia? Does it matter in this clinical context?
• Dizziness in a 40-something with recent stent for inferior OMI
• Tachycardia in cardiology clinic, what is the rhythm?
• How comfortable are you with transcutaneous pacing?
• See how the Queen of Hearts AI is continuously improving
• Chest pain and rapid pacing followed by an unexplained wide complex tachycardia. Time for cardioversion?
• Which Chest Pain patient needs a CT scan?
• Sudden Palpitations in a Young Adult
• An elderly woman with acute chest pain -- real or fake ST Elevation?