New Left Bundle Branch Block is a poor indicator of coronary occlusion
For a couple other very interesting posts on LBBB and STEMI, click here, and here and here for the most recent post. Case 1: A 55 yo male…
Computer algorithms are not sensitive for STEMI
This 29 year old presented in February 2010 after drinking with friends. He started vomiting, then had onset of chest pain and bilateral arm…
Deep and widespread ST depression signifies high risk coronary lesion
This 51 yo male presented with Chest pain. There is ST depression, greater than 3 mm in some leads, in I-III, aVF, and V3-V6. aVR also has ST…
Right Bundle Branch Block with Subtle ST Elevation: LAD 95% occluded
An 81 yo woman presented at 2 AM to the ED with severe substernal chest pressure. This ECG was recorded: There is sinus rhythm with a PVC, and…
Diabetic Ketoacidosis: is there hypokalemia?
This patient presented with diabetic ketoacidosis. The physicians were reluctant to start insulin until they knew that the potassium was not…
Very subtle anterior OMI, TIMI II flow with thrombus
This 48 yo male with no previous MI had a cardiac arrest while playing raquetball. Is there ischemia? Is there occlusion (which is the reason…
Right Bundle Branch Block (RBBB) with Anterolateral STEMI
A 62 yo male with h/o CAD and stent in 1st OM presented with Chest pain while biking. Vitals were normal. An ECG was recorded: There is Right…
Coronary occlusion need not have 1 mm ST elevation; often it does not
A 53 year old male with no previous cardiac history presented with sudden substernal chest pain with tingling of bilateral arms and dyspnea.…
Anterior pseudonormalization
A 68 year old male with no previous h/o MI presented after 2 weeks of exertional dyspnea. On the day of presentation, he was shoveling snow…
HyperKalemia with Cardiac Arrest. Peaked T waves: Hyperacute (STEMI) vs. Early Repolarizaton vs. Hyperkalemia
For more on hyperkalemia, click here (includes a great case of incessant ventricular tachycardia). For more on early repolarization, see these…