Test yourself: how many hours between your diagnosis of OMI and positive STEMI criteria?
Written by Pendell Meyers, with edits by Steve Smith A male in his early 40s presented with intermittent chest/abdominal pain. He admitted to…
Watch what happens when “pericarditis” and morphine cloud your judgment
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD…
Shoulder pain after lifting a heavy box
Written by Pendell Meyers, edits by Steve Smith This will be too easy for most long-time readers, but if you are at that level, sit back and…
It is not a STEMI; it is an opportunity to save myocardium!
I was teaching about subtle coronary occlusion at EKG conference to our residents a couple days ago. About coronary occlusion that does…
A Middle-Aged Man with crescendo angina
A middle-aged male with several comorbidities including DM presented with chest pain. It had been on and off all day, then constant for…
Bizarre T-wave Inversions in a Patient without Chest Pain
This was sent by a recent ultrasound fellow, asking for my ECG diagnosis. He stated that it is “an acute change from previous” in…
30-something with chest pain, a fragmented QRS, and ST Elevation.
A young man presented with acute chest pain. He had no cardiac history. He had no medical history at all. His vital signs…
15 hours of chest pain. Too late for thrombolytics, right? Unstable Angina still exists.
The time window for therapy with thrombolytics is up to 12 hours after the onset of chest pain, based on many studies done in the thrombolytic…
An intoxicated, agitated, 29 year old with chest pain
Here is a one hour lecture on the topic of subtle coronary occlusion, especially on the left anterior descending coronary artery. Case…
Left Bundle with Convex ST Segment: Where is the J-point?
On July 26, I posted a similar problem, but in that case, the huge ST elevation was proportional. Here is another case in which it may…