The Electrocardiographically Silent Circumflex Artery
A 39 yo otherwise healthy man with no risk factors was walking at the mall when he developed chest pressure. He presented to the ED…
Looking for a wall motion abnormality can lead you astray
A Middle-aged male presented with chest pain of 3 hours duration. He has a history of hyperlipidemia only. There is pressure to…
Inferior STEMI with AV Block, Cardiogenic Shock and ST elevation in V1
This is a case I had with one of our superb internal medicine/emergency medicine residents, Marco Salmen, MD. He wrote it up for this…
Shouldn’t need Modified Sgarbossa rule for cath lab here, but it does make the diagnosis certain!
I received this case from a medic (in quotes): “Wanted to know your thoughts on this ECG.” “Woman in early 70’s…
T-wave inversion in a young woman with hyperventilation and carpopedal spasm
This case is another good one contributed by Brooks Walsh, with an excellent review. A 24 year-old African-American female presented to the ED…
Rupture of Aneurysm of the Sinus of Valsalva Presenting as Cardiogenic Shock and Severe Ischemia
This was sent by Nick Jubert, MD, one of our fine EM residency graduates who works at a facility without a cath lab, so has to transfer…
Chest pain in an elderly male.
An elderly male complained of chest pain. Here is his ED ECG: Inferiorly, there are Q-waves with minimal ST elevation and reciprocal ST…
Even with STE in V5 & V6, inferior STE without reciprocal STD in aVL is unlikely to be STEMI
Case 1. A younger middle-aged male called EMS for chest pain. They recorded a prehospital ECG which I do not have, but they did…
Is this Acute Ischemia? More on LVH.
Case 1. A middle aged male presented with chest pain. Here is his ECG (Figure 1): What do you think? Interpretation: All repolarization…