The LAD occlusion formula did not work here. Why?
I received this from a reader, who applied the LAD occlusion (anterior STEMI) formula. The patient presented with chest pain and…
Weakness and Bradycardia
A 70 yo man with a h/o DM, HTN, CAD, chronic renal insufficiency and recent NonSTEMI with pulmonary edema who is on carvedilol and amlodipine…
Chest pain in an 80 year old: What is the diagnosis?
An 80 year old male with h/o CABG presented with CP. Here is his initial ECG (which was identical to his prehospital ECG) at 1517: There…
Chest pain and hypotension in a patient who is 3 weeks post STEMI
A middle aged patient who was 3 weeks s/p STEMI came from cardiac rehab where he developed some chest pain, dyspnea and weakness on the…
Left ventricular Aneurysm Morphology Distorted by Right Bundle Branch Block, Mimicking Acute STEMI with RBBB
This is a complex case that I have reprinted from my article in the EMRA publication, EM Resident, with their permission. I’m…
Subtle Anterior Transient Injury Pattern, Not Appreciated, LAD occlusion spontaneously reperfused
This 41 yo male was cleaning using a chemical and experienced sudden substernal chest burning radiating to both arms with SOB, relieved by…
Serial ECGs confirm initial suspicion of anterior STEMI (LAD occlusion)
A 52 yo man began having substernal chest discomfort and presented 2 hours later. His prehospital ECG, which I cannot find, reportedly…
12 hours of Chest pain in a 40-something
A 40-something yo woman with several coronary risks but no history of coronary disease developed 10/10 “gnawing” retrosternal…
The Same Theme: Large Lateral STEMI is Subtle on the ECG
This is a 34 yo female with no history of CAD who had the onset of chest pain at 0900. It was constant, achy, substernal, 7/10,…
Subtle Lateral ST elevation. False positive. This diagnosis is hard.
Case 1. A middle-aged woman presented with severe substernal crushing chest pain radiating to the left shoulder. This was her…