Blog Coronary ED 
Dr. Smith's ECG Blog
NOVEMBER 14, 2024
I found out that the interventionalist had just finished a case and came to the ED to see about the de-activated case. He saw the ECG and ordered an ED ECG." As per Dr. Smith — I also found it difficult to understand why the admitting ED physicians cancelled the cath lab activation. Kudos to the medics." "I
REBEL EM
JULY 5, 2023
Sepsis) De Winters T waves are the earliest sign of an anterior wall MI but will only be present in ~ 2% of LAD infarcts Patients with Wellens Syndrome on ECG should have a cardiac cath within 24 hours, not necessarily within the first 60 minutes of ED arrival.
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Dr. Smith's ECG Blog
SEPTEMBER 18, 2024
male presents to the ED at 6:45 AM with left sided chest dull pressure that woke him up from sleep at 3am. He arrived to the ED at around 6:45am, and stated the pain has persisted. Here is his ED ECG at triage: Obvious high lateral OMI that does not quite meet STEMI criteria. The pain radiated to both shoulders.
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
[link] Case continued She arrived in the ED and here is the first ED ECG. Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. Detailed coronary artery evaluation not performed.
EMS 12-Lead
AUGUST 18, 2024
David Didlake EMT-P, RN, ACNP @DidlakeDW An adult male self-presented to the ED with palpitations and the following ECG. Readers of the Smith ECG Blog will probably recognize this a very subtle inferior OMI. The VT vs SVT with Aberrancy debate is beyond the scope of this particular blog post. Here is the ECG after 200J.
Dr. Smith's ECG Blog
OCTOBER 27, 2024
The cath lab was deactivated by cardiologist on arrival at ED because it was "not a STEMI". Initial 4th generation troponin I was 10 ng/mL is consistent with large MI due to acute coronary occlusion (OMI). He presented to the ED for evaluation chest pain. There are moderate coronary artery calcifications.
Dr. Smith's ECG Blog
DECEMBER 5, 2023
Acute coronary syndrome in a pediatric patient? An ECG was perfomed on arrival to our ED: NSR with ST elevation II,III, aVF with reciprocal depression in aVL Would you refer this pediatric patient for emergent PCI? Ultimately, cardiac cath was done — revealing patent coronary arteries. mg/L and a normal WBC of 8.8.
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