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9 Min Read

onMarch 24, 2023

85 year old with chest pain, STEMI negative, then normal troponin but with relatively large delta: discharge?

Written by Jesse McLaren, with comments from Smith An 85 year old with a history of CAD presented with 3 hours of chest pain that feels…

7 Min Read

Pendell Meyers

onMay 19, 2022

Chest pain, shortness of breath, T wave inversion, and rising troponin in a young healthy runner.

Written by Pendell Meyers, edits by Smith and Grauer A man in his late 20s with history of asthma presented to the ED with a transient episode…

5 Min Read

Pendell Meyers

onDecember 6, 2021

A man in his 50s with acute chest pain, now resolved, has 2 undetectable troponins. CT Coronary Angiogram?

Written by Pendell Meyers A man in his 50s presented to the ED with chest pain described as pressure, without radiation, acute onset…

11 Min Read

Pendell Meyers

onAugust 8, 2020

A middle aged female with “heartburn” and a “normal ECG” per the computer

This is a re-posting of a Tweet by Robert Jones (@RJonesSonoEM), reproduced with permission, written by Pendell Meyers A middle aged female…

2 Min Read

Steve Smith

onFebruary 16, 2020

A 53 yo woman with cardiogenic shock. Believe me, this is not what you think.

This was sent by a reader. A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. pH was 6.9 and K was…

5 Min Read

Steve Smith

onJanuary 16, 2020

What is the infarct artery????? And have you ever seen a troponin this high?

An elderly woman with h/o stroke and aphasia seemed different to her daughter, and was pointing all over her body as if in pain. They called…

troponin

7 Min Read

Steve Smith

onSeptember 18, 2019

Unusual: Troponin Trajectory to Help Determine Ongoing/Recurrent Infarction vs. Completed Infarction.

A 40-something male with no PMH of any kind presented to urgent care on a weekend (cath team is at home) with cough starting 2…

11 Min Read

Steve Smith

onFebruary 5, 2019

Should Troponin be a Vital Sign? Perhaps, but only if Interpreted Using Pre-test Probability.

An 80-something non-english speaking patient complained of vertigo. He was asked multiple times about chest pain or dyspnea, but…

Steve Smith

onSeptember 21, 2018

New Lecture on High Sensitivity Troponin Protocols in the ED

It is my task to educate our residents on chest pain, ECGs, and troponin. So for years I have been lecturing on the topic of chest pain…

4 Min Read

Steve Smith

onSeptember 1, 2017

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…

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Dr. Smith's ECG Blog

troponin

85 year old with chest pain, STEMI negative, then normal troponin but with relatively large delta: discharge?

Chest pain, shortness of breath, T wave inversion, and rising troponin in a young healthy runner.

A man in his 50s with acute chest pain, now resolved, has 2 undetectable troponins. CT Coronary Angiogram?

A middle aged female with “heartburn” and a “normal ECG” per the computer

A 53 yo woman with cardiogenic shock. Believe me, this is not what you think.

What is the infarct artery????? And have you ever seen a troponin this high?

Unusual: Troponin Trajectory to Help Determine Ongoing/Recurrent Infarction vs. Completed Infarction.

Should Troponin be a Vital Sign? Perhaps, but only if Interpreted Using Pre-test Probability.

New Lecture on High Sensitivity Troponin Protocols in the ED

15 hours of chest pain. Too late for thrombolytics, right? Unstable Angina still exists.