A Woman with 8 hours of Ongoing Crushing Chest Pain and T-wave Inversion
This case was presented in a conference I attended. I had never heard of the case before but made the observations that I give here…
Tachycardia, Fever, and ST Elevation
This patient is approximately 30 years old with some serious baseline illness, and has a history of nonischemic cardiomyopathy. 911 was…
Chest Pain, ST Elevation, and an Elevated Troponin: Should we Activate the Cath Lab?
This was written by Sam Ghali (@EM_RESUS), with a few edits by me. 52-year-old lady presents to the Emergency Department with 2 hours of chest…
Very young man with chest pain, then cardiac arrest
A very young man, approximately 30 year old, called 911 because of 1 hour of severe chest pain. The medics got him into the truck and recorded…
Validation of Smith Modified Sgarbossa Criteria Published in American Heart Journal
We have completed and published the external validation of the Modified Sgarbossa Criteria for Diagnosis of Acute Coronary Occlusion in the…
Formula positive for LAD occlusion. But echo shows no wall motion abnormality! What is it?
Dr. Josu Abecia Valencia, from Spain, asked me my opinion on this case. He has a great Spanish language blog. You can find this…
What is the treatment for this subendocardial ischemia?
This elderly patient had an accidental carbon monoxide poisoning. The patient did not have ischemic symptoms, but we do an ECG routinely…
STE in aVR and diffuse ST depression: It can be ACS or demand ischemia. If ACS, either posterior STEMI or subendocardial ischemia!
A middle-aged male with a history of 2-vessel coronary bypass called 911 because of the relatively sudden onset of severe SOB. He had…
Slightly Peaked T-waves, What is it?
I saw this as I was reading a large a stack of ECGs: What do you think? There is sinus tachycardia. The T-waves are slightly peaked,…
Is this Coronary Occlusion? Cath lab?
This patient presented with cardiac arrest: There is RBBB and ischemic ST elevation in V1-V3. There is ST elevation in aVL and ST…