Should Troponin be a Vital Sign? Perhaps, but only if Interpreted Using Pre-test Probability.
An 80-something non-english speaking patient complained of vertigo. He was asked multiple times about chest pain or dyspnea, but…
Chest pain and Diffuse ST depression, with STE in aVR. You probably think it is left main…..
A 75 year old woman complained of very atypical chest pain, lasting days, worse with movement and palpation. Here is her ECG (ECG-1): There is…
What is the Rhythm?
=============================== Presentation by KEN GRAUER, MD: =============================== The Case: A previously…
Hyperthermia and ST Elevation
This was submitted by Alexandra Schick. Dr. Schick is a PGY3 at the Brown Emergency Medicine Residency in Rhode Island. I remember…
What is going on here?? (The computer called it “STEMI” and “Intraventricular Conduction Delay”!!)
I was asked by my partner to interpret this ECG because the Veritas algorithm had called it “STEMI” and Intraventricular…
A 70-something with Ventricular Paced Rhythm and Chest Pain
A 70-something presented with stuttering chest pain for a couple days that became constant shortly before presentation to the ED. I was shown…
Ventricular Tachycardia? Or SVT with Aberrancy?
This was texted to me, by a recent residency graduate, with the following information: “70-something w hx of TAVR (aortic valve…
Anterior ST Elevation and a High Initial Troponin.
I was shown this ECG with the history that the patient had chest pain: What do you think? This is what I said: “This is not anterior…
Pre-existing Left Bundle Branch Block and Atrial Fib: what is alarming on this routine pre-procedure ECG?
An elderly patient had a pre-procedure ECG (ECG-1). She was asymptomatic. The patient had known Left Bundle Branch Block (LBBB)…
Anterior STEMI Evolves to de Winter’s T-waves
A middle-aged man called EMS for chest pain. This prehospital ECG was recorded: Obvious Anterior STEMI due to proximal LAD occlusion (with STE…