Missed myocardial infarction with subsequent cardiac arrest
A 50 year old male presented to his physician’s office with “heartburn”. The physician recorded this ECG, interpreted…
Man in his 60’s with very subtle ECG and pain not controlled with medical therapy
A male in his 60’s presented 30 minutes after the onset of crushing substernal chest pain. Medics recorded 2 ECGs, one before and…
Crushing Chest pain, but the ECG is not obvious; later there is both RBBB and LBBB
A 63 year old male presented with crushing chest pain. Prehospital BP was 70, but higher in the ED. Here is the initial ECG at 1033 PM:…
Subtle Lateral ST elevation. False positive. This diagnosis is hard.
Case 1. A middle-aged woman presented with severe substernal crushing chest pain radiating to the left shoulder. This was her…
Wait until after the ECG to give Nitroglycerine
Here is the ED ECG of a 58 yo male whose chest pain is resolved: There is sinus rhythm with a PAC (which has aberrant conduction…
Posterior Leads Fail to Diagnose Posterior STEMI
For more cases of posterior MI: https://drsmithsecgblog.com/search/label/posterior%20STEMI A 54 year old male with recent angiogram that…
Apparent ST depression in lead III. Is it MI?
A few days ago, I posted this ECG with “inferior” ST depression that was reciprocal to high lateral MI due to a 2nd diagonal…
“Inferior” ST depression: What is the diagnosis?
This 58 year old man presented at noon with chest pain that began the previous evening and became constant less than one hour prior. Now…
New RBBB and subtle NSTEMI
This 49 year old male presented with chest pain. Initial ECG: sinus with QRS of 128 ms and RBBB, though not obvious. There is T-wave…
35 yo woman with LAD occlusion manifesting with only hyperacute Ts and inferior ST depression, also missed by computer
Click here for other cases of missed STEMI. Click here for cases of early repolarization vs. LAD occlusion. A 35 yo woman had the sudden…