Reciprocal ST depression in II, III, aVF. What is the diagnosis?
A colleague approached me with this ECG of a middle aged male with this ECG; my colleague was worried about acute ischemia. There was no…
Pseudo Right Ventricular MI
This most recent post will help you understand this post here: I was nordic skiing out in the wilds of the Upper Peninsula of Michigan when I…
Five Primary Patterns of Ischemic ST depression, without ST elevation. Some are STEMI-equivalents.
Here are some basic concepts before we get into the ECGs: STEMI and NonSTEMI are arbitrary terms that may confuse the clinician.…
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…