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…
New Paper published on Significance of Reciprocal ST depression in lead aVL
We just published this online in the American Journal of Emergency Medicine: ST depression in lead aVL differentiates inferior ST-elevation…
Paramedics make a great call
A middle-aged male called 911 for chest pain. Here was the first prehospital ECG with pain at 5/10: Computerized QTc is 418 ms. There is…
A 40-something with Chest Pain
A 40 something presented with chest pain. Here is the ECG: QTc 415 ms. What is it? The QRS is normal size and…