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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. The patient proceeded to cath where all coronaries were described as normal with no evidence of any CAD, spasm, or any other abnormality. There was a 0.9%

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

mm of ST segment elevation, V2 and V3 have 1 mm of elevation, v4 has 2 mm of elevation and v5 around 1.5 Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronary artery disease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. What do you think?

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"Pericarditis" strikes again

Dr. Smith's ECG Blog

On review of systems the patient reported back pain for approximately 1 week which he was treating with NSAIDs with minimal relief. They found non-obstructive CAD, with only a 20% stenosis of OM2 and 10% RCA. 15-9/6/2017 ). Figure-1: Excerpt from ESC review on acute pericarditis ( See text ). No acute culprit.

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40-something with severe CP. True + vs. False + high lateral MI. ST depression does not localize.

Dr. Smith's ECG Blog

Is this due to coronary occlusion? The medic activated the cath lab but was refused by the interventionalist, who did not believe that this ECG represented acute coronary occlusion. Important Learning Point: "STEMI" is defined by millimeter criteria (1 mm in limb leads), which this does not meet. Why did I say this? Look at aVF.

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