Wait until after the ECG to give Nitroglycerine
Here is the ED ECG of a 58 yo male whose chest pain is resolved: There is sinus rhythm with a PAC (which has aberrant conduction…
Missed STEMI, spontaneously reperfused
Click here for other very instructive cases of missed STEMI. This is a 48 yo female with no risk factors for CAD had sudden onset of arm…
Would you activate the cath lab prehospital?
A 54 yo with history of hypertension awoke in the AM with substernal chest pain. It did not abate, so at 0930, he called 911.…
Chest pain, SOB, and tachycardia. What is the rhythm? Is it MI?
This was sent to me by a reader from India (Thank you, Rama Krishna). The patient presented recently (age unknown). He had a…
Without reciprocal ST depression or hyperacute T’s, inferolateral MI and myo- or pericarditis are impossible to distinguish
A 63 y.o. female with a past medical history of lupus and MS presents with chest pain and SOB she has never had before, starting…
Prehospital ST Elevation and pain resolve with NTG. ECG and Echo normal in ED.
The resolution of symptoms and the ECG in this case is similar to the last post, but the ST and T-wave morphology of the ECGs are quite…
The last post: why is it not pericarditis? (hint: previous ECG has LV aneurysm morphology)
Yesterday, I posted this interesting transient STEMI. I was asked why it is not pericarditis. I have edited the post (see red text) to…
Transient STEMI, serial ECGs prehospital to hospital, all troponins negative (less than 0.04 ng/ml)
This is a 45 yo male who had an inferior STEMI 6 months prior, was found to have severe LAD and left main disease, and was supposed to be set…
The development of an inferior-posterior STEMI, from prehospital to hospital
For other cases of inferior hyperacute T-wave click here and here. For more on lead aVL, click here and here. Also use labels on the…
Chest pain and LBBB. LBBB resolves and there is V1-V3 T-wave inversion.
A 59 year old man with no cardiac history was at work when he developed very typical substernal chest pressure. He went to a clinic…