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…
Chest pain relieved by Maalox and viscous lidocaine
An otherwise health male in his early 40’s presented with “burning” in his epigastrium that radiated to his throat and was…
I was reading a stack of ECGs yesterday, and saw this one, with no clinical information….
I was reading a stack of ECGs yesterday, and saw this one, with no clinical information: What do you think? (computerized QTc is 429 ms) See…
Male in early 40’s with 1.5 hours of chest pain
A third year medical student sent me this ECG and asked for my interpretation: Recorded 0625 Here is what I wrote back: “Tough…
Incredible Case Demonstrating the Value of Frequent Serial ECGs
This case is presented and written by Vince DiGiulio, (EMT-Critical Care and emergency department tech). As his title shows, he is…
COPD exacerbation, what do the ECG and bedside echo show?
A woman in her 60s presented with a COPD exacerbation. She also complained of some sharp chest pain with coughing. She was in moderate…
Instructions for using subtleSTEMI iPhone app
Some have asked for instructions in using the app: 1. The warning states that it should only be used when the…
A Tough ECG, But Learn From It!
I have to tell this story from my point of view because I don’t want anyone to think that the recognition of LAD occlusion was made in…
Formula to differentiate Normal Variant ST Elevation (Early Repolarization) from Anterior STEMI
Here is a link to the full text of the article in Annals of EM It is critical to use it only when the differential is subtle LAD occlusion vs.…