A Missed STEMI. How could the Diagnosis have been certain?
A middle aged patient presented to the ED with “ischemic-sounding chest pain” of unknown duration. An ECG was recorded: The…
This ECG was texted to me last night with the question: Occlusion or Not?
This ECG was sent along with this text: “Thoughts? Occlusion or not? – context : cardiac arrest:” Here is my answer: …
Transient STEMI, no T-wave Evolution and no Wall Motion Abnormality
A Middle-Aged male had chest pain. Here is his first ECG: Obvious Anterior STEMI (note that among the findings is terminal QRS…
Best Explanation of Terminal QRS Distortion in Diagnosis of Electrocardiographically Subtle LAD Occlusion
This piece was written by Brooks Walsh, who has some great contributions to this blog. There are, of course, some additions and edits by…
The ridiculous pricing of pharmaceuticals in the U.S.
I just wrote this letter to my two senators and my representative, and I hope you’ll do the same: Dear ________, I practice Emergency…
Extreme Bradycardia after Diarrhea and Dehydration. Best ED treatment?
A patient presented with weakness. He was found to be bradycardic, so this ECG was recorded: There is atrial flutter with 3rd degree AV…
“Persistent” Juvenile T-wave article published in Journal of Emergency Medicine
Brooks Walsh and I published this article: http://www.sciencedirect.com/science/article/pii/S0736467915006861 It is online now. If you…
Unstable Angina: Again, it still exists……
A middle aged male with no coronary risk factors presented with new stuttering chest pressure, worse with exertion and better with rest, with…
Spiked Helmet Sign
A middle-aged woman presented with symptoms of mild ischemic stroke. There were no chest symptoms. An ECG was recorded as part of the…
Is this STEMI? No, it is one of the most common reasons for false cath lab activation.
This was contributed by Brooks Walsh, with a little editing and additions, plus a section of false positive cath lab activations added by me.…