Inferior MI with positive troponin: Acute STEMI or Old MI with new NonSTEMI?
A 40 year old male without cardiac risk factors and with no h/o CAD presented with a few days of intermittent typical chest pain. He has…
Angiography can have bleeding complications – be more sure of your STEMI diagnosis in high risk patients
An over 90 yo patient complained of 1 hour of chest pain. There was a h/o CAD with CABG. The prehospital BP was 200…
Prolonged Chest Pain. Is this LV aneurysm or acute anterior STEMI? Acuteness of STEMI and viable myocardium.
This patient had no significant past medical history. He presented with chest pain of 48 hours duration which became worse in the…
What is the Diagnosis?
A 60 yo woman presented with CP and troponin I of 0.85 ng/ml. There is RBBB, but without the usual rSR’ in right precordial…
Reciprocal ST depression in II, III, aVF. What is the diagnosis?
A colleague approached me with this ECG of a middle aged male with this ECG; my colleague was worried about acute ischemia. There was no…
Left ventricular Aneurysm Morphology Distorted by Right Bundle Branch Block, Mimicking Acute STEMI with RBBB
This is a complex case that I have reprinted from my article in the EMRA publication, EM Resident, with their permission. I’m…
This ECG is nearly pathognomonic. What is it?
A 45 yo male with a known history of MI presents with a few hours of chest burning, resolved now. Here is his presenting ECG: There is…
Chest pain, SOB, and tachycardia. What is the rhythm? Is it MI?
This was sent to me by a reader from India (Thank you, Rama Krishna). The patient presented recently (age unknown). He had a…
Dyspnea, resp failure, DNR/DNI, what to do?
79 yo patient with no known previous history of MI and a history of severe dementia presented with acute dyspnea, pulmonary edema, BP 110/70…
Left Ventricular Aneurysm or Anterior Acute STEMI?
I am simply going to post a link to a nice presentation of this at the ems12lead.com blog by Tom Bouthillet.…