Is this STEMI? No, it is one of the most common reasons for false cath lab activation.
This was contributed by Brooks Walsh, with a little editing and additions, plus a section of false positive cath lab activations added by me.…
Low HEART score. Acute LAD occlusion. Detected only by analysis of subtle ECG.
A completely healthy 39 year old woman with no cardiac risk factors had sudden onset of bilateral trapezius pain that radiated around to her…
“How could I convince my interventionalist to come do a cath in the middle of the night?”
I just received this email today. I receive these fairly frequently: Dear Dr. Smith: I am an Emergency physician working in an outlying…
A Male in his 40’s with Decreasing Chest pain – what do you think?
A male in his 40s presented with decreasing chest pain. Here was his first ECG: There is sinus rhythm. The QTc is 379 ms. There is ST…
A Case of Clinical Unstable Angina in the ED
A woman in late middle age with a history of a mild stenosis of the RCA seen on CT coronary angiogram 4 years prior presented 2 hours after…
A Very Subtle LAD Occlusion….T-wave in V1??
This was sent by a former resident. Our residents get a 34 hour ECG course from me over their 3 years, and they often see things I…
Bilateral Arm and Mid Back Pain, BP 250/140, in a 50-something
A 50 something presented with 10/10 bilateral arm and pain between the shoulder blades that started at work. It felt like a…
An elderly man with severe chest pressure……
This was sent to me by a medical student: The patient is an elderly man with no significant past medical history who developed what he…
Is this acute STEMI? LV Aneurysm? Would you give Thrombolytics?
Recently I posted a case describing “Acuteness” on the ECG and how to assess whether it is too late for reperfusion, especially…
Middle Aged Male with Burning Chest Pain — Assess the Entire Clinical Scenario
A middle-aged male presented with “burning” mid chest pain, with radiation to bilateral shoulders (pain radiating to both shoulder is…