Marked ST depression refractory to maximal medical therapy
This 62 year old man, heavy smoker, with no previous medical history, presented after 2.5 hours of substernal chest pressure. He…
Repost: Quiz: Is it LAD occlusion or benign early repolarization?
I posted this back in 2009. I was perusing old posts and had not seen this for a while.…
ST elevation in aVR, with widespread ST depression
This case and ECG was already posted here: https://drsmithsecgblog.com/2010/01/deep-and-widespread-st-depression.html However, because of a…
Is it pulmonary embolism?
This is a 41 year old male with severe asthma who barely avoided intubation. His troponin I returned at 0.130 ng/mL, and here is his…
Answer: pulmonary embolism. Now another, with ultrasound….
This 18 year old presented with syncope and tachycardia. Similar to the last case (the “quiz”), there is sinus tachycardia with…
This is a quiz. The ECG is nearly pathognomonic. Answer at bottom.
A 38 year old with chest pain and SOB: The answer can be found here (a different example of the same pathology, with explanation):…
Anterior MI: Ongoing STEMI, reperfused STEMI, or NonSTEMI?
An 80 yo male presented with chest pain onset 1130 AM. The prehospital ECG was reported to have some “ST depression”,…
LBBB with acute STEMI due to ruptured obtuse marginal, diagnosed with bedside ultrasound
This 74 yo male had just returned to his unit bed after successful PTCA of tight lesions of the first diagonal and obtuse marginal coronaries.…
Classic Evolution of Wellens’ T-waves over 26 hours
A middle-aged patient presented with resolved chest pain. t = 0, presentation to ED: Initial ECG of 50 yo woman who had prehospital chest…
Reperfusion through collaterals associated with nitroglycerin, lead reversal mimics T-wave inversion (and fooled me)
This 69 yo male with a history of HTN, but no h/o CAD, presented with chest pain at an outside hospital at 1700 hours with chest pain onset at…