Unusual: Troponin Trajectory to Help Determine Ongoing/Recurrent Infarction vs. Completed Infarction.
A 40-something male with no PMH of any kind presented to urgent care on a weekend (cath team is at home) with cough starting 2…
Chest pain, pelvic and abdominal pain, hypotension, and severe ischemia on the ECG
An elderly male was lethargic at the nursing home and complained of some pelvic pain, but then also chest pain and abdominal pain. He…
Editorial by Meyers and Smith, full text: Prospective, real-world evidence showing the gap between ST elevation myocardial infarction (STEMI) and occlusion MI (OMI)
Read this full text article on the OMI paradigm, from International Journal of Cardiology: Prospective, real-world evidence showing the gap…
Elderly with Paced Rhythm, Possible Ischemic symptoms, and an Equivocal Smith Modified Sgarbossa ECG
An 80 year old presented with a couple days of SOB, weakness, and diaphoresis. There was no chest pain. Here was her initial ECG: What…
Acute Chest pain in a 50-something, and a “Normal” ECG
Chris Mondie of the Newark Beth Israel Emergency Medicine Residency sent this case A 50-something man presented with acute…
The ECG was correct. The angiogram was not.
This was sent by Cam Mosley and Michael Truax, LSU-Baton Rouge Residency. 74 yo male with previous MI years ago presented with chest pain and…
How does Acute Total Left Main Coronary occlusion present on the ECG?
Post by Smith and Meyers Sam Ghali (https://twitter.com/EM_RESUS) just asked me (Smith): Add this:…
What are all these little spikes?
An elderly woman fell and had an ECG recorded: What are all these spikes? They can’t be anything but artifact, but from what?? These are…
A 60-something who has non-specific generalized malaise and is ill appearing.
An anonymous paramedic sent this. A 60-something with past history only of colon cancer called 911 for non-specific generalized malaise. The…
What is the Diagnosis in this 70-something with Chest Pain?
This is a very commonly missed ECG of a terrible condition. In this case, it was almost dismissed. I present many other similar…