CocaineComparison with Previous ECGCT Coronary Angiogram (CTCA)False positive ECGPrevious ECGQueen knows false positivetype 2 MIVasospasm8 Min Read Steve SmithonMarch 21, 2026 Acute chest pain and ST Elevation. Take a moment to look through the chart! A 40-something man presented with with 10/10 chest pain after cocaine use. The chest pain had been present for 1 hour. On arrival in the ED, a…
Previous ECGRBBB with excessively discordant STDRBBB with LAFB (Left Anterior Fascicular Block)8 Min Read Steve SmithonApril 26, 2022 RBBB and LAFB: Is there a “concordance” of the ST segment in inferior leads? Is the ST depression in V3 due to RBBB only? This ECG was texted to me. I later received this clinical history: The patient in his 60s with h/o COPD had presented with 2…
false positive cath lab activationPrevious ECG1 Min Read Steve SmithonJune 16, 2013 37 yo with 1.5 hours of burning chest pain A 37 year old with a history of DM on metformin complained of acute onset of burning chest pain. He called 911. They did an ECG but it…
posterior leadsposterior STEMIPrevious ECG5 Min Read Steve SmithonJanuary 1, 2013 Precordial ST depression. What is the diagnosis? A middle aged male with no h/o CAD presented with one week of crescendo exertional angina, and had chest pain at the time of the…
Previous ECG1 Min Read Steve SmithonDecember 27, 2012 Before diagnosing STEMI, try to find a previous ECG! A man in his 50’s complained of typical chest pain. Here is his ED ECG: There is a Q-wave in V2, with ST elevation and hyperacute…