Should we activate the lab? A simple but important lesson
Written by Pendell Meyers A man in his 60s called EMS for sudden chest pain and shortness of breath. He was found in moderate respiratory…
CJEM Open Access OMI Quality Improvement Publication
Just published in the CJEM: From STEMI to occlusion MI: paradigm shift and ED quality improvement Jesse T. T. McLaren…
Hyperacute T-waves — missed. Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) may be due to transient thrombotic Occlusion MI.
Coronary thrombosis (twice in the same patient!!) without a stenosis or even a culprit Do not miss the last image at the bottom that shows the…
Did the posterior leads help here? Why not just get good at STDmaxV1-V4?
Written by Pendell Meyers A middle aged woman presented with chest pain and dyspnea. Her exam and vitals were within normal…
Dynamic ST Depression in precordial leads. Does this transient STD signify subendocardial ischemia?
This case was written up by one of our fantastic 3rd year residents, Michael Fischer. Edits by Smith. A mid 60s male with past history…
Collapse, Ventricular Tachycardia, Cardioverted, Comatose on Arrival. OMI is a clinical diagnosis.
A middle-aged woman cried out, then collapsed. She had bystander CPR. First responders palpated a pulse. Paramedics found…
A man his 50s with chest pain. What happens when you treat with morphine rather than with reperfusion?
Written by Pendell Meyers A man in his late 50s presented to the ED with 3 days of left chest pain radiating into the jaw and neck. He…
Chest pain and RBBB with right axis deviation, and downsloping ST Elevation. What is downsloping ST Elevation?
4916132 A 50-something male smoker with h/o Diabetes, but with no cardiac history presented by ambulance with acute chest…
Bradycardia with a Wide Complex. Sometimes 2 pathologies are present. Which?
An elderly woman was found to be bradycardic. She was awake with a BP of 120/70. Here is her prehospital ECG: What do you think? I…
What is this ST Depression? (Hint: there are 2 etiologies)
Don’t miss Ken Grauer’s comments at the bottom! An elderly woman is found down in her bedroom. On arrival, she was alert,…