Dynamic, Reversible, Ischemic T-wave inversion mimics Wellens’. All trops negative.
A middle-aged man presented with 7-8/10 non-radiating chest tightness to the left chest wall, associated with nausea but no diaphoresis, that…
Found comatose with prehospital ECG showing “bigeminal PVCs” and “Tachycardia at a rate of 156”
This patient with a history diabetes was found with a GCS of 4. Prehospital EKG and strips (not shown) had “heart rate 156”…
The 4 Physiologic Etiologies of Shock, and the 3 Etiologies of Cardiogenic Shock
A 60-something presented with hypotension, bradycardia, chest pain and back pain. She had a h/o aortic aneurysm, aortic insufficiency,…
Saddleback ST Elevation. Is it STEMI? Is it type II Brugada?
A 50-something presented with epigastric and chest pain. Here is his ECG: What do you think? QTc 388 ms. Computer interpretation: SINUS…
Large T-waves and a Computer Interpretation of ***Acute MI***
This ECG was texted to me with no information: I answered: “Show me the whole 12-lead.” Here it is: Computer Interpretation: SINUS…
Chest Pain and RBBB. What do you think?
An elderly woman presented with 25 minutes of chest pain after working out. This ECG was texted to me and I viewed it on my phone hurriedly…
A Computer “Normal” ECG. What is the diagnosis?
I posted this one on October 9, but it was buried in a discussion of a paper on triage ECGs: Another Inadequate Paper Published on Triage…
Thrombus propagation on 10 serial Prehospital ECGs: Can you explain the progression?
This patient called 911 for chest pain. The medics did an amazing job of recording serial ECGs. Time zero Hyperacute T-wave and subtle…
Extreme Bradycardia: a Case-Based Lesson in Pacing
I tell the residents: “The pacemaker is just common sense: if there is no beat, it provides one; if there is one, it keeps itself from…
10th Anniversary of Dr. Smith’s ECG Blog: First Post was November 7, 2008
This was the first post 10 years ago today: ST depression: is it ischemia? No, hypokalemia. A bit of history: K. Wang formerly sent out a…