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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. This has been discussed many times before on this blog. In-depth discussion is beyond the scope of this blog. Serial ECGs enhance the diagnosis of acute coronary syndrome. Washam, J. Peacock, W. Pollack, C.

STEMI 85
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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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Early repol or anterior OMI?

Dr. Smith's ECG Blog

He noted that his father died from a heart attack in his early 50s prompting his presentation to the emergency department. He reported substernal chest pressure with radiation to his left arm that started at work several hours prior to arrival and had somewhat improved since onset.

OR 108
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A man in his 70s with chest pain

Dr. Smith's ECG Blog

He stated it was similar to prior heart attacks. We've shown many cases on Dr. Smith's ECG Blog of subtle ECG findings that rapidly evolve into dramatic ST-T wave changes. Today's patient is high-risk ( ie, in a high "prevalence" group for having an acute coronary event ). The pain was still ongoing at arrival.

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Circumflex Occlusion May be Subtle or Invisible on the ECG

Dr. Smith's ECG Blog

male presents because he "thought he might be having a heart attack." First, this patient had a known stent in the "marginal" artery and thought he was having a heart attack. Case 2 A 38 year old male with h/o smoking only c/o a few hours of severe substernal chest pain; he thinks he is having a heart attack.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

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. (The

ACS 52