Acute Dyspnea in a Middle Aged Male
A middle aged man with several CAD risk factors presented with one week of intermittent shortness of breath and then sudden severe…
Prehospital Ventricular Fibrillation in a Young Woman. What is the Diagnosis?
An under 30 yo woman collapsed and was found in ventricular fibrillation, and was successfully defibrillated. Here is her prehospital ECG:…
Male in his 40’s with chest pressure: what is the diagnosis
This 40-some year old patient complained of chest pressure and had this ECG recorded: See comments and diagnosis below The providers were a…
Modified Sgarbossa Rule Published Online: Annals of Emergency Medicine
Link: Diagnosis of ST-Elevation Myocardial Infarction in the Presence of Left Bundle Branch Block With the ST-Elevation to S-Wave Ratio in a…
Angiography can have bleeding complications – be more sure of your STEMI diagnosis in high risk patients
An over 90 yo patient complained of 1 hour of chest pain. There was a h/o CAD with CABG. The prehospital BP was 200…
Pericarditis, or Anterior STEMI? The QRS proves it.
A young otherwise healthy man presented with 4 hours of sharp 10/10 substernal chest pain. It has been constant since then. He…
Spontaneous Reperfusion and Re-occlusion – My Bad Thinking Contributes to a Death
This is a case I had about a decade ago. This is a 51 year old who was playing cards with his friends when he started to have left hand…
Reciprocal (Negative) Hyperacute T-waves. What is the Diagnosis?
I was shown this ECG and asked if I think it is a STEMI. What do you think? Answer Below I answered that it does not meet any criteria…
Gunshot wound to the chest with ST Elevation
A 32 year old presented with a gunshot wound that seems to have entered the anterior chest with a downward trajectory, traversing…
Crushing Chest pain, but the ECG is not obvious; later there is both RBBB and LBBB
A 63 year old male presented with crushing chest pain. Prehospital BP was 70, but higher in the ED. Here is the initial ECG at 1033 PM:…