Right Bundle Branch Block with Subtle ST Elevation: LAD 95% occluded
An 81 yo woman presented at 2 AM to the ED with severe substernal chest pressure. This ECG was recorded: There is sinus rhythm with a PVC, and…
Diabetic Ketoacidosis: is there hypokalemia?
This patient presented with diabetic ketoacidosis. The physicians were reluctant to start insulin until they knew that the potassium was not…
Very subtle anterior OMI, TIMI II flow with thrombus
This 48 yo male with no previous MI had a cardiac arrest while playing raquetball. Is there ischemia? Is there occlusion (which is the reason…
Right Bundle Branch Block (RBBB) with Anterolateral STEMI
A 62 yo male with h/o CAD and stent in 1st OM presented with Chest pain while biking. Vitals were normal. An ECG was recorded: There is Right…
Coronary occlusion need not have 1 mm ST elevation; often it does not
A 53 year old male with no previous cardiac history presented with sudden substernal chest pain with tingling of bilateral arms and dyspnea.…
Anterior pseudonormalization
A 68 year old male with no previous h/o MI presented after 2 weeks of exertional dyspnea. On the day of presentation, he was shoveling snow…
HyperKalemia with Cardiac Arrest. Peaked T waves: Hyperacute (STEMI) vs. Early Repolarizaton vs. Hyperkalemia
For more on hyperkalemia, click here (includes a great case of incessant ventricular tachycardia). For more on early repolarization, see these…
Pseudonormalization of T waves, Coronary occlusion without 1 mm ST elevation
See 6 even better cases of T-wave pseudonormalization here. Here is another case. Do not miss this one: A Middle-Age Male with Chest…
Posterior ST Elevation MI in the Setting of Right Bundle Branch Block, with Posterior Leads V7-V9
This is a 68 year old man who had a resuscitated cardiac arrest. His prehospital ECG looks identical to this one which was recorded upon…
STEMI best seen in PVC
See this post for a wide complex that hides ischemic findings. See this post for a difficult diagnosis in the context of a wide complex. Case…