ACEP Now

OCTOBER 29, 2024

Does that normal troponin and ECG obviate the need for cardiology consultation for my patient with a concerning story for acute coronary syndrome? Coming into triage, I see a young man—Georgian-speaking—bracing himself with a hand against the wall and holding his lower abdomen.

Emergency Department 59

Emergency Department ALS Emergency Medical Services OR 59

EMS 12-Lead

APRIL 2, 2022

He reported a history of ischemic cardiomyopathy with coronary stent placement approximately 10 years prior, but could not recall the specific artery involved. So, when I first began teaching ECGs and writing my books (in the early 1980s) — I decided to synthesize my impressions of the literature into what I felt (e.g. Figure 1-2.

ALS 130

ALS STEMI Coronary OR 130

Dr. Smith's ECG Blog

SEPTEMBER 27, 2023

The ECG below show a very clean and text book example of triangular QRST waveform also know "Shark Fin". Other coronaries were normal. ECG#1 There is a regular tachycardia with a ventricular rate of about 180 bpm. Smith comment : When there is a regular wide complex tachycardia, first assess whether it is sinus or not. Is there OMI?

Defibrillator 133

Defibrillator OR Coronary EMS 133

Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

I believe that I was the first to represent Wellens as a reperfusion syndrome, in my book , The ECG in Acute MI , pages 22-23 and 51, and in chapter 27 on Reperfusion and Reocclusion. There are also subtly hyperacute T-wave in I, aVL, and V2-V6. The S-wave is reconstituted. The inferior findings are much less pronounced. Lemkes et al.

STEMI 116

STEMI ACS Critical Care Coronary 116

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

The above principles are all well illustrated with this figure from my book, The ECG in Acute MI (2002). It is important to recognize that coronary thrombosis is dynamic , with spontaneous opening and lysing of the thrombus in the infarct-related artery (we all have endogenous tPA and plasmin to lyse thrombi). Akkerhuis KM, et al.

Coronary 52

Coronary STEMI ALS Emergency Department 52

FOAMfrat

JUNE 25, 2024

Since then, I’ve developed a habit for outdoor recreation and light versions of mountaineering, which led me to realize that altitude illness can occur in much less extreme conditions than I’d previously thought and that these pathophysiologies might actually be relevant to those of us not living in Nepal.

OR 97

OR Coronary ALS 97

Dr. Smith's ECG Blog

APRIL 26, 2017

Note 2 other similar cases at the bottom that come from my book, The ECG in Acute MI. See similar cases below from my book, The ECG in Acute MI New 4-Variable Formula I have published a new formula for Early Repolarization vs. Subtle LAD Occlusion that solves the problem of false positives due to LVH by adding a 4th variable, QRS in V2.

STEMI 52

STEMI ACS ED Coronary 52