The Skeptics' Guide to EM
JULY 2, 2022
His father had a minor heart attack at the age of 63. With a negative initial troponin, this gives him a HEART score of 4. If we thought about ACS, we brought them in. Case: You are working a shift in your local community emergency department (ED) when a 47-year-old male presents with chest pain. AEM June 2022.
Dr. Smith's ECG Blog
NOVEMBER 23, 2022
He stated it was similar to prior heart attacks. ST depression maximal in V1-V4, in the context of ACS symptoms and unexplained by QRS abnormality or tachydysrhythmia, should be considered posterior OMI until proven otherwise. The pain was still ongoing at arrival. He also noted a bilateral "odd feeling" in his arms.
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Dr. Smith's ECG Blog
AUGUST 9, 2024
He reported a history of “Wolf-Parkinson-White” and “heart attack” but said neither had been treated. Similarly, the OMI paradigm respects ACS as a dynamic process in which ECG changes reflect the phase of myocardial injury and risk stratify which patients may benefit from emergent PCI.
Dr. Smith's ECG Blog
OCTOBER 10, 2022
He reportedly told his family "I think I'm having a heart attack", then they immediately drove him to the ED, and he was able to ambulate into the triage area before he collapsed and became unresponsive. CPR was initiated immediately. There is also STD in V2-V4 (but maximal in V5-V6).
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