In chest pain, if the ECG is not diagnostic, can the medics safely leave the patient at home?
67 year old female complaining of epigastric pain that radiates to herchest. Relief with burping. Symptoms had been ongoing for about 1…
A woman in her 50s with chest pain. No diagnostic STE (that worthless diagnosis: “NSTEMI”). What is it and what happened?
Sent by anonymous, written by Pendell Meyers A woman in her 50s presented with acute chest pain and shortness of breath. She appeared well…
Chest pain, serial ECGs STEMI negative, first troponin normal: cancel cath lab activation? Exemplary care by an emergency physician!
Submitted by Matthew McArthur, recent emergency physician graduate and regular reader of Dr. Smith’s ECG Blog, ECG Cases, and ECGweekly…
Atypical symptoms. Should we give thrombolytics?
This was sent by an old friend who works at a hospital without PCI capabilities, and far from one that does. So if there is OMI, he gives…
Dyspnea and chest pain. O2 saturation 88%.
This ECG was texted to me: dyspnea and chest pain. O2 saturation 88%. What was my response? My response: “She has some sort of chronic…
Chest pain in a rural hospital: is this pericarditis or does the patient need thrombolytics?
Written by Mazen El-Baba, with edits from Jesse McLaren A 60-year-old woman presented to a rural emergency department with sudden-onset,…
Wide complex Tachycardia in an 85 year old
An 85 year old called 911 for palpitations. Medics found her with good blood pressure but fast rate and recorded this ECG? Opinion of Zoll…
A man in his 70s with acute chest pain. How did management affect the outcome?
Sent by anonymous, written by Pendell Meyers A man in his 70s presented with acute chest pain, shortness of breath, nausea, vomiting, and…
New Lecture. October 23, 2025. Replace STEMI/NSTEMI with OMI/NOMI, and AI in the Diagnosis of OMI
This is from Cardiology Grand Rounds at Medical College of Wisconsin, via Zoom, on October 23, 2025. The woman you see there is Dr. Jacquelyn…
Chest pain with “Non-diagnostic ECG”. What is the finding? What do you think happened?
Written by Magnus Nossen A 69-year-old woman with a 50-year history of smoking contacted EMS due to sudden onset chest pain. The chest pain…