Dr. Smith's ECG Blog

Instructive ECGs in Emergency Medicine Clinical Content

Associate Editors:
— Pendell Meyers & Ken Grauer (2018)
— Jesse McLaren & Emre Aslanger (2022)
— Willy Frick (2024)

editors

A young woman with chest pain, cath lab activated

This case came from a friend whose sister was the patient. She knew I was interested in ECGs, so she took a photo of this one.

A young woman presented with acute chest pain.

This was her presenting ECG:

What do you think?

This is clearly Brugada phenotype.  There is downsloping ST Elevation in V1 and V2.  To an experienced interpreter, it is clearly not due to OMI.  And it is clearly Brugada phenotype.

The conventional algorithm did not interpret Brugada. 

In fact, it read: ** **ACUTE MI / STEMI ** **

The physicians caring for the patient activated the cath lab for “STEMI”.

The interventionalist and cath team came to the hospital, and when the interventionalist saw the ECG, he inquired further and elicited a family history of Brugada syndrome.  He then cancelled the cath lab activation.

Further history revealed that she had had many episodes of syncope.  

She was subsequently diagnosed with Brugada syndrome and received an ICD.

I sent this ECG to the Queen of Hearts:

Also note: how the digitization takes a sideways ECG and makes it perfect!

You may think this is ECG is so obvious that it needs no AI to diagnose. But the conventional algorithm diagnosed STEMI, and an emergency physician activated the cath team based on this ECG.

The Queen of Hearts PM Cardio App is now available in the European Union (CE approved) the App Store and on Google Play.  For Americans, you need to wait for the FDA.  But in the meantime:

YOU HAVE THE OPPORTUNITY TO GET EARLY ACCESS TO THE PM Cardio AI BOT!!  (THE PM CARDIO OMI AI APP)


If you want this bot to help you make the early diagnosis of OMI and save your patient and his/her myocardium, you can sign up to get an early beta version of the bot here.  It is not yet available, but this is your way to get on the list.

https://share-eu1.hsforms.com/18cAH0ZK0RoiVG3RjC5dYdwfyfsg

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Ventricular Fibrillation, ICD, LBBB, QRS of 210 ms, Positive Smith Modified Sgarbossa Criteria, and Pacemaker-Mediated Tachycardia

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A 29 year old male with chest pain, ST Elevation, and very elevated troponin T

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