Dr. Smith's ECG Blog
NOVEMBER 15, 2023
Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. CORONARY ARTERIES: Exam was not directly tailored for coronary artery evaluation, noting recent diagnostic coronary angiogram.
The Skeptics' Guide to EM
JULY 2, 2022
Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? He has no history of coronary artery disease. Date: June 30th, 2022 Reference: McGinnis et al. AEM June 2022.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
EMS 12-Lead
APRIL 9, 2024
He denied any specific prodrome of gross palpitations, however did endorse feeling quite dizzy just before the event. Given no clinical prelude of anginal (or equivalent) descriptors, prior to the acute event, risk stratification of the ECG and Troponin was pursued via Echo and nuclear Myocardial Perfusion Imaging (MPI).
Dr. Smith's ECG Blog
JANUARY 25, 2024
A 40-something with severe diabetes on dialysis and with known coronary disease presented with acute crushing chest pain. Smith offers the unique perspective of assessing the initial ECG of a patient who has had prior events — and, who now presents with new symptoms. Here is his ED ECG: What do you think?
REBEL EM
SEPTEMBER 21, 2023
What Your Gut Says: The patient has a tachydysrhythmia which may be the presentation of acute coronary syndrome (ACS) even though the patient has no ischemic symptoms. Essentially, we are using the troponin assay to find patients with ACO who may be benefited by coronary interventions or risk factor modification.
Dr. Smith's ECG Blog
JUNE 23, 2024
The patient was treated as possible NSTEMI and underwent coronary angiography about 4 hours after presentation. TIMI 3 means the rate of passage of dye through the coronary artery is normal by angiography.) Initial hsTnI was 384 ng/L. The report describes a 60% proximal LAD lesion with TIMI 3 flow.
Dr. Smith's ECG Blog
OCTOBER 1, 2023
This patient in today's case was a man in his 60s with a known history of coronary disease, including prior stents. This history immediately places this patient in a high -prevalence population for having an acute event. It's OK not to be certain from the initial ECG as to whether or not an acute event is occurring.
Expert insights. Personalized for you.
103 
Let's personalize your content