CAD Definition Emergency Department 
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting." Just because you don't see hemodynamically significant CAD on angiogram does not mean it is not OMI. I could have told you this (and did tell you this) without an MRI.
Dr. Smith's ECG Blog
NOVEMBER 22, 2023
Patient stated that he has had glucose over 400 even though he has not missed any doses of insulin. Lead aVL in ECG #2 now shows subtle-but-real coved ST depression, that is the mirror-image opposite picture of the new coved ST elevation that we now see in lead III.
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Dr. Smith's ECG Blog
MAY 19, 2020
She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). A followup ECG was recorded 2 days later: No definite evidence of infarction. If there is any evidence of atherosclerosis, modifiable CAD risk factors should be treated aggressively.
Dr. Smith's ECG Blog
JULY 3, 2018
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. Lead aVL, for example, has a definite J-wave. Stat echo would also be helpful. mV compared to 0.05-0.1
Dr. Smith's ECG Blog
MARCH 24, 2023
Written by Jesse McLaren, with comments from Smith An 85 year old with a history of CAD presented with 3 hours of chest pain that feels like heartburn but that radiates to the left arm. Below is the ECG. What do you think? There’s sinus bradycardia, first degree AV block, normal axis, delayed R wave progression, and normal voltages.
Dr. Smith's ECG Blog
DECEMBER 31, 2024
She presented to the Emergency Department at around 3.5 The procedure was described as very complex due to severe multivessel CAD, but ultimately PCI was successfully performed to the ostial LCX. Final Diagnosis: "STEMI" (of course, as you can see in the ECGs above, this is not true, by definition this was NSTEMI.
Dr. Smith's ECG Blog
JANUARY 15, 2025
Case A 68 year old man with a medical history of hypertension, hyperlipidemia, and CAD with stent deployment in the RCA presented to the emergency department with chest pain. And so was missed "golden opportunity" to make a definitive diagnosis long before the 11 hours that it ultimately took to get this patient to the cath lab.
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