36 year old with chest pain after chest wall surgery
5881888 Recent chest surgery. Had been to surgeon’s office complaining of chest pain. Assumed to be post-surgical. SOB with…
Interns are not (yet) poisoned by the STEMI/NSTEMI paradigm
This case was written up by Kuan-Yu (Evan) Lin with some edits by Willy Frick. I (Willy) had the pleasure of working with Evan when he was a…
Hypertrophic Cardiomyopathy with dehydration and chest pain
A middle-aged man with a history of HOCM presented with 24 hours of chest pain, still active. He stated that he had been dehydrated for…
The worst thing you can be when you have this ECG is to be a young woman
This was contributed by a great paramedic, Drew Williams. He now is his agency’s “Clinical Improvement Analyst for…
Hypotension, chest pain, and precordial ST depression maximal in V3. Is this OMI?
One of my partners showed me this ECG of a 60-something male with a history of MI and stent who was hypotensive with chest pain, and…
Patient with Heart Transplant has ventricular fibrillation arrest — resuscitated
2635859 A middle-aged male Immediate post-resuscitation. We were aware that ST Elevation can be a result of the low flow state in…
Should you record posterior leads? Should you give thrombolytics for chest pain with this ECG (if PCI not available)?
This was sent by Kirk Lufkin and was diagnosed by a Physician Assistant who works with him by the name of Danielle Hutcheson. They…
If you saw this EKG completely isolated from clinical context, how would you interpret it?
Written by Willy Frick This blog has repeatedly made the point that ECGs must always be interpreted in clinical context. But…
A sick elderly patient with nonspecific symptoms
Written by Pendell Meyers An elderly woman summoned EMS for generalized weakness and multiple vague complaints. She was confused and ill…
What happens when a clinic does not have troponin testing for chest pain patients? Stress testing?
Written by Willy Frick — Commentary added below on 6/4/2025 by Ken Grauer regarding ETT A 90 year old man with history of hypertension,…