June 2019 - Dr. Smith’s ECG Blog

Home Archives for June 2019

7 Min Read

onJune 28, 2019

Inferior Subtle ST elevation: straight ST segment, but also no reciprocal ST depression in aVL: which is more important?

60-something with h/o MI and stents presented with chest pain radiating to the back and nausea/vomiting. Time zero What do you think? There is…

4 Min Read

Steve Smith

onJune 26, 2019

Serial Evolving ECGs all diagnostic of LAD OMI, but never meet STEMI criteria

A 60-something called 911 for chest pain. Medics recorded an ECG at time zero: What to you think? There is no ST elevation, but V2 has a…

6 Min Read

Steve Smith

onJune 23, 2019

2 ECGs texted to me. Minimal STE in inferior leads. How important is it?

These 2 ECGs were texted to me with the words “I think acute MI, but cardiology does not.” I believed these to be 2 serial ECGs:…

7 Min Read

Pendell Meyers

onJune 22, 2019

ST segment concavity is just one small piece of the puzzle that is pattern recognition

Written by Pendell Meyers Here are two striking examples from a single shift highlighting the fallibility of the standard “smiley…

4 Min Read

Steve Smith

onJune 20, 2019

Do you recognize these ECGs? STEMI? LVH? What?

What do you think of these ECGs? I came across the first one reading it blind for a study. I was certain I knew the diagnosis, and went…

5 Min Read

Steve Smith

onJune 18, 2019

Sudden Cardiac Arrest: why does the Heart Just Die?

A 60-something was outside walking with a friend when he suddenly stated that he “felt weak,” without chest pain or SOB or…

4 Min Read

Steve Smith

onJune 17, 2019

More precise interpretation of the results of the 4-variable formula.

If you haven’t heard of the 4-variable formula for differentiating Normal Variant ST Elevation in V2-V4 from Ischemic ST Elevation due…

5 Min Read

Steve Smith

onJune 15, 2019

Patient with Dyspnea. You are handed a triage ECG interpreted as “normal” by the computer.

I was handed this ECG of a patient with dyspnea: What do you think? Computer interpretation: Normal EKG Physician Overread (Final…

5 Min Read

Steve Smith

onJune 11, 2019

A 20-something male with acute chest pain

I was texted this ECG with the words “sudden onset CP in a 20-something”: What do you think? This was my response: “This is…

6 Min Read

Steve Smith

onJune 9, 2019

A patient with chest pain that is resolving. Computer interprets ED ECG as completely Normal.

I posted this case a long time ago, before I started ranting about ECGs that are called completely normal by the computer. A 60-something with…

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Dr. Smith's ECG Blog

Month: June 2019

Inferior Subtle ST elevation: straight ST segment, but also no reciprocal ST depression in aVL: which is more important?

Serial Evolving ECGs all diagnostic of LAD OMI, but never meet STEMI criteria

2 ECGs texted to me. Minimal STE in inferior leads. How important is it?

ST segment concavity is just one small piece of the puzzle that is pattern recognition

Do you recognize these ECGs? STEMI? LVH? What?

Sudden Cardiac Arrest: why does the Heart Just Die?

More precise interpretation of the results of the 4-variable formula.

Patient with Dyspnea. You are handed a triage ECG interpreted as “normal” by the computer.

A 20-something male with acute chest pain

A patient with chest pain that is resolving. Computer interprets ED ECG as completely Normal.