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Dynamic OMI ECG. Negative trops and negative angiogram does not rule out coronary ischemia or ACS.

Dr. Smith's ECG Blog

By Smith, peer-reviewed by Interventional Cardiologist Emre Aslanger Submitted by anonymous A 53 y.o. For more on MINOCA — See My Comment in the November 16, 2023 post in Dr. Smith's ECG Blog ). male presents to the ED at 6:45 AM with left sided chest dull pressure that woke him up from sleep at 3am.

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Proportionality is a major element in the ECG Diagnosis of OMI.

Dr. Smith's ECG Blog

I published, and Emre Aslanger externally validated, the 4-Variable formula for differentiating the ST Elevation of LAD OMI from Normal ST Elevation. Let's stretch out the QRS vertically so it is not so tiny: On upper left is the original. On the right are the precordial leads stretched vertically, so that the QRS is not tiny.

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The Concomitant Use of Calcium and Diltiazem for Rapid Atrial Fibrillation

REBEL EM

They utilized EMR to gather comprehensive data on patients who received IV calcium and IV diltiazem, or IV diltiazem monotherapy for the treatment of patients with AF/AFL with RVR. The study was dependent on EMR documentation which is prone to error. Hypotension in these patients can complicate management.

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Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal

REBEL EM

History of liver disease, history of substance abuse disorder, and history of delirium tremens were also extracted from the hospital EMR. Background: The emergency department is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines.

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Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

This was contributed by Co-editor Emre Aslanger, an interventional cardiologist in Turkey. See My Comment at the bottom of the page in the May 19, 2020 post in Dr. Smith's Blog ). AslangerE A 65-year-old gentleman presented to the emergency department after experiencing two recent ICD shocks in the preceding hours.

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Sometimes even ST Elevation meeting criteria is not enough to be convincing

Dr. Smith's ECG Blog

Written by Emre Aslanger. Emre is a new Editor of the Blog. You can find many examples on this blog attesting that. I am sure that it is not for the readers of this blog. This is also a clear ECG for the readers of this blog, but may be hard for someone who is not used to seeing non-mainstream ECGs.

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The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

REBEL EM

Epinephrine – 10ug/mL, 10mL syringe Phenylephrine – 100ug/mL, 10mL syringe Phenylephrine bolus doses from 100-200ug and epinephrine 10-20ug administered every 2-5 minutes pursuant to provider order Inclusion Criteria: Adults age >18 years old Received at least one bolus dose of phenylephrine or epinephrine pre-filled syringes Exclusion (..)