ST elevation on prehospital ECG is gone upon arrival to the ED
This is a 55 yo male with chest pain. The medics recorded the first ECG, which shows unequivocal ST elevation in leads V4-V6. Our medics have…
Atrial fibrillation with rapid ventricular response with ECG injury pattern
This elderly woman presented hypotensive, pale, and tachycardic. Here is the initial ECG. There is an irregularly irregular rhythm…
Right BBB and Bigeminy, with Anterior STEMI
This is from a 53 year old male smoker with chest pain. Here is the initial EKG: There is grouped beating, in couplets. Both complexes in each…
Pure (Isolated) Posterior STEMI — not so rare, but often ignored!
Click here for more cases of posterior MI, and more explanation Case 1. This is a 44 yo male with h/o HTN, CABG at age 34, and 2 drug eluting…
Circumflex Occlusion May be Subtle or Invisible on the ECG
Case 1 Below are 2 cases of circumflex or obtuse marginal (branch of circumflex) occlusions showing how subtle they may be: A 52 y.o. male…
Right Bundle Branch Block with Acute ST Elevation Seen Best on Prehospital ECG
This patient is 38 years old with hyperlipidemia. He was at the gym when he had the onset of chest pain. EMS was activated and recorded the…
Elderly With No Symptoms, Wellens’s Thus Overlooked, Then ST Elevation Doubted
Here is a case of an 89 year old woman who had syncope but no chest pain or shortness of breath. Her initial EKG (#1) shows some ST depression…
Hyperacute T waves
Below are several examples of hyperacute T waves. Click here for more great examples of hyperacute T-waves. Click here for cases of…
ST depression limited to Inferior leads is reciprocal to high lateral wall and represents STEMI
When there is inferior ST depression, one is tempted to diagnose “inferior ischemia”. However (paradoxically and mysteriously)…
If there is high suspicion for ischemia, do serial EKGs and pay attention to them!
Case 1) This is the initial EKG of a 60 yo male with a couple days of stuttering chest pain. He is pain free at the time of the EKG at 2100.…