Back to basics: ECGs are dynamic, get serial ECGs and learn the OMI progression
Written by Pendell Meyers A male in his 40s experienced off and on chest pain at rest several times in the past 48 hours. The pain returned…
75 year old with acute chest pain: 6 bad reasons not to cath.
Written by Jesse McLaren, edits by Smith A 75 year old without cardiac history presented to the emergency department with 3 hours of acute…
What is this Pattern? Is an initial troponin I of 45 ng/L diagnostic?
A middle aged male presented with acute chest pain. He was seen by Emily Dawra, one of our 2nd year EM residents, about to become 3rd year in…
This is Excellent OMI Care
This is the first post on our new blogger, WordPress. Notice that the URL is different from before (drsmithsecgblog.com). We’re hoping…
A woman in her 60s with acute chest pain and shortness of breath
Written by Pendell Meyers A woman in her 60s had acute chest pain and shortness of breath. EMS arrived and recorded this ECG (no baseline ECG…
HEART Score Zero. Computer Normal ECG. Troponin Undetectable. Speckle Tracking Echo normal.
A completely healthy 30-something year old woman with no cardiac risk factors had sudden onset of bilateral trapezius pain that radiated…
Dizziness in a 40-something with recent stent for inferior OMI
Dizziness is so unlikely to be OMI without an obvious ECG, that I am going to pretend that this patient presented with chest pain. The…
Are there hyperacute T-waves? And how can we know?
A 50-something man presented with worsening severe exertional chest pain which was just resolving as he had an ECG recorded in triage. Time…
Hyperacute T wave or not: do any of these 4 ‘STEMI’ ECGs have Occlusion MI?
Written by Jesse McLaren, with edits from Meyers Four patients presented with chest pain or shortness of breath, and ECGs labeled…
If you were this patient, would you prefer to be managed with the Queen of Hearts?
Written by Pendell Meyers A man in his early sixties with no significant medical history (including a “negative cardiac workup a few…