New upright T-wave that is NOT pseudonormalization
A 79 yo female presented with crescendo angina. She has a history of anterior STEMI a few years ago treated with tPA. She has DM, HTN, and…
Cardiac Arrest, Ventricular Fibrillation, Inferior and Right ventricular MI (RVMI) or “Pseudoanteroseptal MI”
A 56 yo f with h/o HTN and hypercholesterolemia called EMS from home after onset of L chest pain radiating to the left arm. Before EMS…
Cardiac Arrest suddenly after blood loss, is it due to MI? Also, when the rhythm looks like torsade, it is usually not.
A 74 yo f with ESRD on dialysis and h/o CAD bumped her access fistula and began to bleed profusely. She had a prehospital BP of 60, pulse 70,…
Inferolateral ST elevation might be pericarditis, but not with Reciprocal ST depression in aVL
This 47 yo male with 2 risk factors had onset of substernal CP while watching TV and smoking a cigarette. It felt “sharp” as if…
Inferior ST depression in ACS is reciprocal to ST elevation in aVL
For this topic, see also this post: https://drsmithsecgblog.com/2009/01/st-depression-limited-to-inferior-leads.html This 72 yo male with h/o…
Beware crescendo angina in patient with known CAD
A 73 yo f with hx of CAD (CABG x 2), DM, HTN, hyperlipidemia and known previous LAD occlusion, presented to the ED at t=0 with chest pain,…
Cardiac Arrest, from Ventricular Fibrillation.
The computerized QTc is 472, but the actual QTc is well over 600 ms. The T-waves are almost like a sine wave, and there are very prominent…
Atypical Left Bundle Branch with acute RCA occlusion
This 70 year old woman with a history of left bundle branch block presented with 10 hours of dyspnea. Notice there is QRS widening with a wide…
Note to Readers
Dear Readers: I only post, on average, 2-3 times per month. However, I encourage you to read old posts. There are now 46 over the last 18…
21 yo F with Syncope has Right Ventricular Hypertrophy and Pulmonary Hypertension
This 21 yo otherwise healthy woman, with a history of one episode of syncope 3 months prior, had onset of SOB, chest tightness, and epigastric…