DIffuse ST Elevation with Apical Ballooning: is it Takotsubo Stress Cardiomyopathy?
A 33 year old male had 2 days of chest pain, intermittently relieved with acetaminophen (paracetamol) and diclofenac. He came to the ED…
Ultrasound Before ECG for Chest pain? Whoever gets there first. Use of Speckle Tracking.
A male in his mid 30s with no cardiac history but some cardiac risk factors had onset of chest pain and arrived in the ED within 30 minutes of…
Anatomy of a Missed LAD Occlusion (classified as a NonSTEMI)
A male in his 50’s called 911 for constant 8/10 midsternal chest pressure. Here was his prehospital ECG: Computerized QTc is 423…
Subtle Anterior STEMI Superimposed on Anterior LV Aneurysm Morphology
A male in his early 30s was playing soccer when the ball hit him in the chest. At some point after this, he began having chest pain.…
Dyspnea on Exertion in a Middle Aged Woman.
A middle-aged woman presented to the ED with increasing dyspnea on exertion. She had a normal physical exam except for a heart rate…
Massive Osborn Waves of Severe Hypothermia (23.6 C), with Cardiac Echo
This patient was found down in the Minnesota Winter. He felt cold and was unresponsive. He had palpable pulses at a rate of 30,…
You Must Read the ECG in Clinical Context….
An elderly male presented with cough and dyspnea, progressive for several days. He had no chest pain. Among his many tests, the…
Cardiac arrest, severe acidosis, and a bizarre ECG
A middle aged male had an unwitnessed PEA arrest associated with cocaine use. Whether there was a shockable rhythm prior to PEA is…
Wellens’ waves are NOT equivalent to Wellens’ syndrome: Pseudo-Wellens’ due to LVH and HTN
A 20 year old male with end stage renal disease (ESRD) and hypertension presented with 1 hour of chest pain (“cramps”). He was…
Persistent Juvenile T-wave Pattern
This article is written by Brooks Walsh, MD, an emergency physician, as well as Steve Smith, and with help from Ken Grauer, who is quite…