CAD ED Heart Attack 
The Skeptics' Guide to EM
JULY 2, 2022
Case: You are working a shift in your local community emergency department (ED) when a 47-year-old male presents with chest pain. His father had a minor heart attack at the age of 63. With a negative initial troponin, this gives him a HEART score of 4. He is also the CME editor for Academic Emergency Medicine.
Dr. Smith's ECG Blog
JANUARY 9, 2023
No family history of sudden cardiac death, cardiomyopathy, premature CAD, or other cardiac issues. No similar symptoms in the past. No prior exertional complaints of chest pain, dizziness, lightheadedness, or undue shortness of breath. He denied headache or neck pain associated with exertion.
Dr. Smith's ECG Blog
OCTOBER 10, 2022
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. The value of Stat Echo in the ED for confirming clinical and ECG suspicion of acute PE cannot be overstated!
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