An 80-year-old with chest pain and a wide QRS. Should you give thrombolytics?
Written by Magnus Nossen Today’s patient is an 80-year-old man with stage 5 chronic kidney disease (CKD), but not yet receiving…
Can you treat Non-STEMI with thrombolytics if it is OMI (Occlusion MI)? Of course!
This case was sent by an old residency friend, Kirk Lufkin. He works in a small hospital in Northern Michigan. Case A 61…
Chest pain and Saddleback STE. For Which of these 6 Cases should we Activate the cath lab? And how does the Queen of Hearts perform?
Smith Introduction: Saddleback ST Elevation is often an OMI mimic, so one needs to scrutinize these ECGs!! Written by Magnus Nossen Below are…
See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.
Written by Magnus Nossen The patient in today’s case is a male in his 70s with hypertension and type II diabetes mellitus. His wife…
Repost: Syncope, Shock, AV block, RBBB, Large RV, “Anterior” ST Elevation in V1-V3
I came across this post from 2015 while answering a question on Twitter, and decided to repost it:…
A 41 year old with chest pain and a Nondiagnostic Triage ECG. Thrombolytics prior to transfer for PCI.
This was sent by Tom Fiero, from Merced CA, and an avid reader of the blog. “A 41 yo man presented with sudden severe chest pain, onset…
A Text Message in the Middle of the night. Do you give thrombolytics?
I awoke in the morning and discovered a text with this ECG that was sent 6 hours prior by a former resident: “60 year old with classic…
Incredible case of evolution of terminal QRS distortion, then resolution after thrombolytics
For more on Terminal QRS distortion, see these posts: Best Explanation of Terminal QRS Distortion in Diagnosis of Electrocardiographically…
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…