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SGEM#421: I Think I’d Have a Heart Attack – Maybe Not in a Rural Area?

The Skeptics' Guide to EM

Date: November 22, 2023 Reference: Stopyra et al. She is the cofounder of FOAMcast and a […] The post SGEM#421: I Think I’d Have a Heart Attack – Maybe Not in a Rural Area? She is the cofounder of FOAMcast and a […] The post SGEM#421: I Think I’d Have a Heart Attack – Maybe Not in a Rural Area? AEM November 2023.

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SGEM#370: Listen to your Heart (Score)…MACE Incidence in Non-Low Risk Patients with known Coronary Artery Disease

The Skeptics' Guide to EM

Date: June 30th, 2022 Reference: McGinnis et al. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Date: June 30th, 2022 Reference: McGinnis et al. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Reference: McGinnis et al.

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46 year old with chest pain develops a wide complex rhythm -- see many examples

Dr. Smith's ECG Blog

He reported a history of “Wolf-Parkinson-White” and “heart attack” but said neither had been treated. Serial ECGs enhance the diagnosis of acute coronary syndrome. Bigger et al. below) Other examples of AIVR: Young man with Gunshot wound to right chest with hemorrhagic shock, but bullet path not near heart.

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A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

Repeat CT angio chest (not CT coronary, unclear what protocol) showed possible LAD aneurysm and thrombus. Finally, coronary angiography was performed (at least 5 days after presentation) which confirmed LAD aneurysm with large thrombus burden, TIMI 0 flow, thrombectomy performed.

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Pay now (in the evening) or pay later with interest (in the middle of the night).

Dr. Smith's ECG Blog

He reports this was similar to how he felt when he had his heart attack 4 years prior, now s/p 4 stents. PMCardio Queen of Hearts AI Model: The Queen of course also thinks it is acute OMI, for the same reasons. In this study by Lupu et al., He states that it feels like burning and pressure, like GERD.

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