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Better Watch Your Back… Finding the Needle in the Haystack.

Core EM

The Case A 71-year-old male with a history of chronic obstructive pulmonary disease, hyperlipidemia, and peptic ulcer disease presents to the emergency department with substernal chest pain radiating down the right arm and dyspnea that began acutely while “running” up the stairs from the subway.

STEMI 173
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SGEM#370: Listen to your Heart (Score)…MACE Incidence in Non-Low Risk Patients with known Coronary Artery Disease

The Skeptics' Guide to EM

Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Coronary 100
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Early repol or anterior OMI?

Dr. Smith's ECG Blog

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. Chest Pain – Benign Early Repol or OMI?

OR 111
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Better Watch Your Back… Finding the Needle in the Haystack.

Core EM

The Case A 71-year-old male with a history of chronic obstructive pulmonary disease, hyperlipidemia, and peptic ulcer disease presents to the emergency department with substernal chest pain radiating down the right arm and dyspnea that began acutely while “running” up the stairs from the subway.

STEMI 130
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Wide Complex Tachycardia

Core EM

Risk factors that increase the likelihood of VT include history of previous myocardial infarction, known coronary artery disease, and structural heart disease. The patient did not respond to medical therapies trialed in the emergency department and ultimately underwent radio-frequency ablation with the return of normal sinus rhythm.

Coronary 246
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ECG Pointers: STEMI Equivalents from the American College of Cardiology

EMDocs

Traditionally, emergency providers looked for signs of ST-segment elevation myocardial infarction (STEMI) to indicate the need for intervention. Emergency physicians have recognized for some time that there are many occlusions of the coronary arteries that do not present with classic STEMI criteria on the ECG.

STEMI 110
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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. What do you think?

E-9-1-1 139