Dr. Smith's ECG Blog

MAY 13, 2024

Written by Destiny Folk, MD, Adam Engberg, MD, and Vitaliy Belyshev MD A man in his early 60s with a past medical history of hypertension, type 2 diabetes, obesity, and hyperlipidemia presented to the emergency department for evaluation of chest pain. 4) Lastly, the QRS amplitude in V2 (both the R- and S- waves) are measured.

OR 108

OR STEMI Heart Attack Coronary 108

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. Guagliumi, G., Iwaoka, R.

E-9-1-1 116

E-9-1-1 OR Coronary ACS 116

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. Electrical injuries in the emergency department: an evidence-based review. Emerg Med Pract.

Operating Room 52

Operating Room ACS Critical Care Coronary 52

Dr. Smith's ECG Blog

JANUARY 9, 2024

She presented to the emergency department after a couple of days of chest discomfort. The patient is an older woman with known coronary disease and an ICD-Pacemaker implanted because of a history of VT ( V entricular T achycardia ). The last echocardiography 12 months ago showed HFmrEF. The ECG below was recorded.

Coronary 98

Coronary ACS ED OR 98

Dr. Smith's ECG Blog

DECEMBER 29, 2023

It was ongoing on arrival in the emergency department. STEMI criteria is bad at differentiating between normal variant and acute coronary occlusion or reperfusion, and initial troponin levels don't differentiate between occlusive and non-occlusive MI 3. Below is the old ECG (on top) and then new ECG (on bottom).

STEMI 70

STEMI Coronary OR ALS 70

ACEP Now

JUNE 6, 2023

Notoriously elusive, with a high misdiagnosis rate, thoracic aortic dissection (AD) can mimic many conditions, including acute coronary syndrome (ACS, the most common), gastroesophageal reflux disease (GERD), stroke, and spinal-cord compression. 1 Opioids or anxiolytics are often given to patients whose diagnosis of AD is missed or delayed.

ACS 85

ACS ALS ED OR 85

Dr. Smith's ECG Blog

APRIL 17, 2023

The remainder of his Emergency Department stay was uneventful. Here is the clinical informaton on ECG 2: A man in his 50s presented to the Emergency Department with acute chest pain that started within the past few hours. The patient was transferred to the PCI center non-emergently over the next few hours.

OR 52

OR STEMI ACS Emergency Department 52

Dr. Smith's ECG Blog

OCTOBER 2, 2021

Because the patient's pain had resolved completely and cardiology had declined immediate intervention, the patient was admitted but continued to board in the emergency department. Approximately 4 hours after arrival, the patient was re-examined by the emergency physician. The iStat POC assay is 0.08

OR 52

OR ACS STEMI Coronary 52

ECG & Echo Learning

JANUARY 18, 2023

This page summarises the most current recommendations for the management of acute coronary syndromes with persistent ST-segment elevations (i.e I B Patients transferred to PCI centres can bypass the emergency department to undergo primary PCI without delay. STEMI , ST-segment elevation acute myocardial infarction ).

STEMI 40

STEMI Coronary OR Defibrillator 40

Dr. Smith's ECG Blog

DECEMBER 14, 2018

The pain resolved as he arrived to the emergency department. Even if troponins are negative and infarction is not documented — dynamic ECG changes in association with new chest discomfort is indication for investigation. He had 2 episodes over the past 2 days of similar chest tightness. Chest Pain scores can be misleading.

ED 52

ED STEMI Coronary Emergency Department 52

Dr. Smith's ECG Blog

JUNE 8, 2023

According to the STEMI paradigm, the patient doesn’t have an acute coronary occlusion and doesn't need emergent reperfusion, so the paramedics can bring them to the ED for assessment, without involving cardiologists. Cardiology documented “late presentation STEMI but likely aborted given resolution of ST changes from EMS to hospital.”

STEMI 63

STEMI Coronary Paramedic ALS 63

Dr. Smith's ECG Blog

APRIL 8, 2015

Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful. 2) Boston syncope rule: J Emerg Med. The ROSE (Risk Stratification of syncope in the emergency department) Study. 2007 Oct; 33(3): 233–239.

Emergency Department 52

Emergency Department E-9-1-1 ED ALS 52