Precordial swirl Archives - Dr. Smith’s ECG Blog

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5 Min Read

onNovember 14, 2025

A woman in her 50s with chest pain. No diagnostic STE (that worthless diagnosis: “NSTEMI”). What is it and what happened?

Sent by anonymous, written by Pendell Meyers A woman in her 50s presented with acute chest pain and shortness of breath. She appeared well…

7 Min Read

Pendell Meyers

onOctober 27, 2025

A man in his 70s with acute chest pain. How did management affect the outcome?

Sent by anonymous, written by Pendell Meyers A man in his 70s presented with acute chest pain, shortness of breath, nausea, vomiting, and…

7 Min Read

Magnus Nossen

onOctober 23, 2025

Chest pain with “Non-diagnostic ECG”. What is the finding? What do you think happened?

Written by Magnus Nossen A 69-year-old woman with a 50-year history of smoking contacted EMS due to sudden onset chest pain. The chest pain…

11 Min Read

Emerson Floyd

onSeptember 13, 2025

Five Lessons from a Misleading ECG

This was written by Emerson Floyd, with comments by Smith I first saw this this ECG (#1) when I woke up to a text message a fellow EM…

10 Min Read

Jesse McLaren

onAugust 10, 2025

Chest pain with acute RBBB: just another NSTEMI?

Written by Jesse McLaren, with comments from Smith A 75 year old with a previous MI and ischemic cardiomyopathy presented with 6/10 chest and…

9 Min Read

Willy Frick

onJuly 1, 2025

A subtle ECG and a subtle angiogram

Written by Willy Frick A man in his early 40s with no past medical history experienced acute onset crushing chest pain and dyspnea. The chest…

4 Min Read

Steve Smith

onJune 27, 2025

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…

Willy Frick

onMarch 30, 2025

Everyone sees ST depression, but what does it mean?

8 Min Read

Willy Frick

onMarch 30, 2025

Everyone sees ST depression, but what does it mean?

Written by Willy Frick A man in his 70s with hypertension and type 2 diabetes mellitus presented with chest pain which awoke him from…

5 Min Read

Steve Smith

onMarch 27, 2025

Even in retrospect, no one could see it.

This was sent to me by a former resident who is outstanding at reading ECGs for OMI. “Hi Steve wonder what you think of this ecg in a 60…

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Precordial swirl

A woman in her 50s with chest pain. No diagnostic STE (that worthless diagnosis: “NSTEMI”). What is it and what happened?

A man in his 70s with acute chest pain. How did management affect the outcome?

Chest pain with “Non-diagnostic ECG”. What is the finding? What do you think happened?

Five Lessons from a Misleading ECG

Chest pain with acute RBBB: just another NSTEMI?

A subtle ECG and a subtle angiogram

What is this Pattern? Is an initial troponin I of 45 ng/L diagnostic?

Everyone sees ST depression, but what does it mean?

Everyone sees ST depression, but what does it mean?

Even in retrospect, no one could see it.