Spiked Helmet Sign
A middle-aged woman presented with symptoms of mild ischemic stroke. There were no chest symptoms. An ECG was recorded as part of the…
Is this STEMI? No, it is one of the most common reasons for false cath lab activation.
This was contributed by Brooks Walsh, with a little editing and additions, plus a section of false positive cath lab activations added by me.…
4 Cases Discussing Terminal QRS Distortion in Diagnosis of Anterior MI
Case 1: The last case had this prehospital ECG: The Emergency Physician activated the cath lab, and it was cancelled. Besides the…
ECG Diagnostic of STEMI. But Interventionalist cancels the cath lab.
Prehospital A male in his 80s was crossing the street, felt weak, and sat down. He denied LOC, chest discomfort or dyspnea. He had…
PseudoSTEMI and True ST elevation in Right Bundle Branch Block (RBBB). Don’t miss case 4 at the bottom.
Case 2. A middle-aged male with h/o CAD and stents presented with typical chest pressure. Here is his ECG: The resident was…
Low HEART score. Acute LAD occlusion. Detected only by analysis of subtle ECG.
A completely healthy 39 year old woman with no cardiac risk factors had sudden onset of bilateral trapezius pain that radiated around to her…
A large R-wave in lead V1. And why is the PR interval not short?
This 20-something male presented with alcohol withdrawal, alcoholic hepatitis, and alcoholic steatosis. There was no chest pain or…
Approach to Potential Ischemic Chest Pain in the Emergency Department
This is a lecture for my residents that I have done since the early 90’s, and update every 3 years. There is a lot of new data in…
A 21 year old with Chest pain
A 21 year old presented with typical chest pain. Here is his ECG: There is inferior and lateral ST elevation. Pericarditis, right?…
“How could I convince my interventionalist to come do a cath in the middle of the night?”
I just received this email today. I receive these fairly frequently: Dear Dr. Smith: I am an Emergency physician working in an outlying…