Dr. Smith's ECG Blog

JUNE 18, 2013

So I went to look at the chart and here is the history: This patient with no h/o CAD had a couple of episodes of chest pain during the day, then presented with one hour of substernal chest pain that had some reproducibility but also improved from 10/10 to 5/10 with nitroglycerine. Ann Emerg Med 1998;31(1):3-11.

STEMI 52

STEMI Coronary ALS CAD 52

Dr. Smith's ECG Blog

MARCH 20, 2023

I finished my residency of Emergency Medicine and I’m working at a great Emergency Department here in Brazil. Angiogram soon after (around 4 hrs after presentation) showed multi vessel CAD, with culprit lesion total occlusion of the first obtuse marginal branch (OM1), which was stented. No more troponins were obtained.

STEMI 52

STEMI ACS CAD ED 52

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. The pain initially started the day prior to presentation. The ST elevation from today is ~0.2

ACS 52

ACS STEMI Coronary CAD 52

FOAMfrat

DECEMBER 26, 2024

IF YOU OR A LOVED ONE NEEDS HELP, CALL 988 OR SEEK CARE AT A LOCAL EMERGENCY DEPARTMENT. CAD notes indicate that the caller was walking in the park and came across a vehicle in the far corner of the parking lot. REMEMBER, IF YOU ARE TREATING A SUICIDE ATTEMPT SURVIVOR, DO NOT PASS JUDGMENT.

Epinephrine 116

Epinephrine OR First Responder Emergency Management 116

EMS 12-Lead

AUGUST 14, 2022

Otherwise, no admission of CAD, HLD, or family history of sudden cardiac death. A 12 Lead ECG was recorded: This is pathognomonic for classic deWinter T waves, indicative of LAD occlusion.

MICU 130

MICU STEMI CAD Coronary 130

Dr. Smith's ECG Blog

JANUARY 20, 2024

Written by Pendell Meyers A man in his late 30s with history of hypertension, tobacco use, and obesity presented to the Emergency Department for acute chest pain which started approximately 3 hours prior to arrival, in the setting of a very stressful situation. Scattered other nonobstructive CAD.

STEMI 120

STEMI CAD ED ALS 120

Dr. Smith's ECG Blog

AUGUST 9, 2019

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. This was a 100% acute LM occlusion.

Coronary 52

Coronary STEMI ACS ALS 52

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.

STEMI 52

STEMI Coronary CAD OR 52

ECG & Echo Learning

JANUARY 18, 2023

IIa C Pre-hospital logistics Management Recommendation Level of evidence The pre-hospital care of STEMI patients should be organized regionally (including all components from the emergency medical dispatch to catheterization laboratory) in order to provide reperfusion therapy as early as possible.

STEMI 40

STEMI Coronary OR Defibrillator 40

EMDocs

JANUARY 8, 2025

These are very commonly encountered in the emergency department, so being able to correctly identify the rhythm is extremely important. He has a history of CHF, dilated cardiomyopathy, HTN, HLD and CAD. This week, we are finishing 4 of a 4-part series tackling tachydysrhythmias. Lets dive in! Take a look: Figure 3.

CAD 98

CAD EMS Emergency Department ED 98

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. Also : See Ken Grauer's excellent comments at the bottom. He developed it only 20 minutes prior to presentation while cutting branches outside.

Coronary 67

Coronary ED CAD Paramedic 67

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. The chest pain was described as severe pressure radiating to both shoulders. Vital signs were within normal limits. hours since onset.

Coronary 118

Coronary ACS STEMI CAD 118