Small ECG Changes, Big Clinical Wins: How Repeat ECGs Save Lives

ECG Weekly Workout with Dr. Amal Mattu

HPI

A 64-year-old man with PMHx of hypertension and obesity presents to the emergency department with 2 days of worsening chest pain. Pain is central, intermittent, worsens with exertion, and has become more severe over the past 2 hours. Pain is now associated with lightheadedness and diaphoresis. The arrival ECG was nonspecific and the following repeat ECG is obtained for worsening symptoms:

Before watching this week’s workout, carefully review the ECG and consider the following:

    1. Would you activate the cath lab?
    2. When do you get repeat ECGs?
    3. Do you repeat an ECG with every repeat troponin?