Key Points ACS Dynamics: Occluded arteries in ACS can spontaneously reperfuse and reocclude, making ECG findings variable. Limitations of Computer Interpretation: Subtle STE is often missed by computerized ECG interpretation;…
Key Points STEMI Equivalent: The de Winter ECG pattern is an uncommon STEMI equivalent indicative of an unstable proximal occlusion of the LAD (left anterior descending coronary artery). This pattern…
Key Points Pattern Recognition: The South African Flag Sign is characterized by: ST-segment elevation (STE) in leads I, aVL, and V2. ST-segment depression in lead III. Subtle but visually distinctive…
Key Points STEMI Diagnosis and Contiguous Leads: While current guidelines typically require ST elevation (STE) in at least two contiguous leads for the diagnosis of STEMI, this practice is not…
Key Points Diagnosis in LBBB: LBBB does not exclude the diagnosis of occlusion myocardial infarction (OMI). Acute MI can be identified despite the repolarization changes that LBBB causes, particularly with…
Key Points ACS Dynamics: ACS is complex and dynamic, with occluded arteries potentially reperfusing and reoccluding at any time. ECG Pattern Recognition: Mastering ECG pattern recognition in ACS is crucial…
Key Points Pattern Recognition: New-onset Right Bundle Branch Block (RBBB) and Left Anterior Fascicular Block (LAFB) occurring together is a high-risk ECG finding. Often associated with proximal Left Anterior Descending…
A 51-year-old man presents to the emergency department with acute chest pain that has progressively worsened over the past 3 hours. Pain radiates to the jaw and is associated with…
A 50-year-old woman presents to the emergency department with acute chest pain. The following ECG is obtained on arrival:
A 72-year-old woman with a past medical history of diabetes, coronary artery disease, and heart failure presents to the emergency department with acute onset chest and back pain. Pain is…
Key Points Early Repolarization (ER): A common ECG finding that can produce widespread ST-segment elevation, often mimicking STEMI or acute pericarditis. ST Segment Morphology: Convex and horizontal ST-segment morphology is…
A 58-year-old woman is brought into the emergency department by paramedics with chest pain and diaphoresis. The following EMS ECG was obtained:
A 70-year-old man presents to the ED with ischemic chest pain. The following ECG is obtained:
A 70-year-old man presents to the ED with radiating chest tightness, nausea, and diaphoresis. The following ECG is obtained:
A 52-year-old man with history of hyperlipidemia and smoking presents to the ED with 2 hours of radiating chest pressure associated with diaphoresis and dyspnea. The following ECG is obtained: