Dr. Smith's ECG Blog

JANUARY 9, 2024

She presented to the emergency department after a couple of days of chest discomfort. The patient is an older woman with known coronary disease and an ICD-Pacemaker implanted because of a history of VT ( V entricular T achycardia ). The last echocardiography 12 months ago showed HFmrEF. The ECG below was recorded.

Coronary 119

Coronary ACS ED OR 119

EMDocs

MARCH 25, 2024

2, 3 Biliary POCUS can help decrease patient length of stay in the Emergency Department. Video 3: Coronary approach to the gallbladder POCUS Findings Sonographically, the gallbladder is situated in the right upper quadrant as an elongated pear-shaped organ on the inferior surface of the liver. J Educ Teach Emerg Med.

ALS 98

ALS Coronary Emergency Department ED 98

The Skeptics' Guide to EM

SEPTEMBER 28, 2024

Date: September 23, 2024 Reference: Essat et al. Annals of Emergency Medicine, May 2024 Guest Skeptic: Dr. Casey Parker is a Rural Generalist from Australia who is also an ultrasounder. The patient has no specific risk factors for acute coronary syndrome (ACS) or dissection. Reference: Essat et al.

Emergency Department 236

Emergency Department ACS Coronary ALS 236

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch). The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization.

Coronary 128

Coronary ACS Emergency Department Epinephrine 128

Dr. Smith's ECG Blog

MAY 13, 2024

Written by Destiny Folk, MD, Adam Engberg, MD, and Vitaliy Belyshev MD A man in his early 60s with a past medical history of hypertension, type 2 diabetes, obesity, and hyperlipidemia presented to the emergency department for evaluation of chest pain. 4) Lastly, the QRS amplitude in V2 (both the R- and S- waves) are measured.

OR 120

OR STEMI Heart Attack Coronary 120

Dr. Smith's ECG Blog

AUGUST 9, 2024

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. Serial ECGs enhance the diagnosis of acute coronary syndrome. Annals of Emergency Medicine , 31 (1), 3–11. link] Fesmire, F.

STEMI 107

STEMI Coronary Heart Attack ACS 107

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Accessed May 28, 2024. What do you think? Labs obtained and notable for an elevated troponin I to 0.10

E-9-1-1 138

E-9-1-1 ACS Emergency Department Coronary 138

Dr. Smith's ECG Blog

JANUARY 17, 2024

Using the current paradigm, can you tell which patient had an acute coronary occlusion? STEMI vs OMI Now let’s see the rest of the ECG: can you tell which patient has an acute coronary occlusion, and which ECG has hyperacute T waves? Using T wave amplitude, can you tell which ECG has hyperacute T waves? J Electrocardiol 2017 2.

STEMI 118

STEMI Coronary ALS OR 118

EMDocs

NOVEMBER 4, 2024

54 It is vital to consider dangerous epigastric pain mimickers like acute coronary syndrome (ACS), hepatobiliary disease, or pancreatitis. The Treatment of Acute Pain in the Emergency Department: A White Paper Position Statement Prepared for the American Academy of Emergency Medicine. J Emerg Med. Acad Emerg Med.

ED 106

ED E-9-1-1 Emergency Department ALS 106

Don't Forget the Bubbles

DECEMBER 5, 2023

A very Merry Christmas from the BW team, and all the Best Wishes for 2024! Data was collected at 2 emergency departments in America and included assessment by both clinicians and patients for a total of 31 patients. Wounds are a common presentation to both adult and paediatric emergency departments.

Coronary 111

Coronary Epinephrine CPR Emergency Department 111

ACEP Now

JUNE 14, 2024

And, finally, patients with a history of COPD frequently present to the emergency department with dyspnea. Although dyspnea in this setting likely represents an AECOPD, other emergent differentials must be considered. ECG evaluates for dysrhythmias, acute coronary syndrome, or signs of right heart strain. Ann Emerg Med.

ALS 52

ALS Coronary OR ED 52

REBEL EM

FEBRUARY 3, 2025

Annals of Emergency Medicine. PMID: 39066765 What They Did: The study involved the development of a deep ensemble AI model using ECG data from a prospective percutaneous coronary intervention registry in Korea. Development of Clinically Validated Artificial Intelligence Model for Detecting ST-segment Elevation Myocardial Infarction.

STEMI 84

STEMI Coronary Emergency Department ALS 84

Dr. Smith's ECG Blog

DECEMBER 16, 2024

Cardiology wanted a CT of the aorta to rule out dissection, presumably partly due to the very high blood pressure readings, but also because it is hard for people to believe that a 20-something woman could have acute thrombotic coronary artery. Coronary malperfusion due to type A aortic dissection: mechanism and surgical management.

STEMI 105

STEMI Coronary Critical Care ED 105

Dr. Smith's ECG Blog

DECEMBER 20, 2024

Written by Willy Frick with edits by Ken Grauer An older man with a history of non-ischemic HFrEF s/p CRT and mild coronary artery disease presented with chest pain. The following ECG was obtained in the emergency department during active chest pain. He said he had had three episodes of chest pain that day while urinating.

Defibrillator 102

Defibrillator Coronary ALS Emergency Department 102

Dr. Smith's ECG Blog

NOVEMBER 10, 2024

EMS gave aspirin and nitroglycerin, and the patient noted significant improvement on arrival to the Emergency Department. My Comment , by K EN G RAUER, MD ( 11/10 /2024 ): = Think of today's case as a check of your skill in recognizing when to activate the cath lab. Why did the Repeat ECG look Better than ECG #1?

STEMI 81

STEMI OR ED EMS 81

Dr. Smith's ECG Blog

JANUARY 15, 2025

Case A 68 year old man with a medical history of hypertension, hyperlipidemia, and CAD with stent deployment in the RCA presented to the emergency department with chest pain. Also : See Ken Grauer's excellent comments at the bottom. He developed it only 20 minutes prior to presentation while cutting branches outside.

Coronary 67

Coronary ED CAD Paramedic 67

EMDocs

FEBRUARY 3, 2025

SLE is considered an atypical risk factor for cardiovascular disease and acute coronary syndrome(8,9,11). Published 2024 Jan 2. PMID 37827694 The post Systemic Lupus Erythematosus: ED presentations, evaluation, and management appeared first on emDOCs.net - Emergency Medicine Education. Ann Rheum Dis. 2024;83(1):15-29.

ED 69

ED E-9-1-1 ALS OR 69

Don't Forget the Bubbles

NOVEMBER 18, 2024

The other important moment to always think of the heart (sorry, cardiologists, I don’t think about the heart 24/7) is when a collapsed neonate presents to your emergency department, especially if blood pressure is present. This is one of the situations where you must not forget to feel for femoral pulses. L., & Carcillo, J.

OR 59

OR Critical Care Coronary Emergency Department 59

Dr. Smith's ECG Blog

DECEMBER 31, 2024

Written by Pendell Meyers A woman in her 70s with known prior coronary artery disease experienced acute chest pain and shortness of breath. She presented to the Emergency Department at around 3.5 She was emergently transferred to a PCI center. KEY Points: DSI does not indicate acute coronary occlusion!

Coronary 118

Coronary ACS STEMI CAD 118

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

He presented to the emergency department for evaluation. Rates of occurrence of PIRP have decreased drastically in the era of percutaneous coronary intervention. Incidence and Prognosis of Pericarditis After ST-Elevation Myocardial Infarction (from the Acute Coronary Syndrome Israeli Survey 2000 to 2013 Registry Database).

STEMI 89

STEMI ALS OR Coronary 89