STEMI

Weekly Workout March 25, 2024

Interesting Cases from UMMC, Part I

A 63-year-old man presents to the emergency department with acute chest pain and an episode of syncope. The following ECG is obtained, and the cath lab is activated for suspected…

Weekly Workout March 18, 2024

Literature Review: Shark Fin or “Triangular” ST segment morphology

A 61-year-old male is brought to the ED with acute substernal chest pain and diaphoresis. The following ECG is obtained:

Weekly Workout March 4, 2024

Literature Review: Resolution of ST elevation in STEMI

Paramedics are transporting a middle aged male with chest pain and an obvious inferior STEMI. They arrive to the emergency department and the following ECG is obtained on arrival about…

Weekly Workout January 29, 2024

2024 EMS Cases Part II

A 56-year-old woman is being brought in by EMS for palpitations. The following EMS ECG is obtained and transmitted:

Weekly Workout July 17, 2023

STAT ECG Diagnoses: important considerations in hypotensive patients with acute cardiac ischemia

Test Yourself

Weekly Workout February 6, 2023

STAT ECG Diagnoses: how to identify acute coronary occlusion myocardial infarction in patients with right bundle branch blocks (RBBB)

A 61-year-old man presents to the emergency department with acute chest pain associated with diaphoresis and appears pale. While obtaining a history and performing a physical exam the patient has…

Weekly Workout January 22, 2023

STAT ECG Diagnoses: how to identify acute coronary occlusion myocardial infarction in patients with left ventricular hypertrophy (LVH) with strain

A 60-year-old man presents to the emergency department with central chest pain for the last 2.5 hours concerning for cardiac ischemia. The following ECG is obtained on arrival:

Weekly Workout January 8, 2023

STAT ECG Diagnoses: differential diagnoses for low voltage QRS complexes and ventricular arrhythmias in patients with left ventricular assist devices (LVADs)

An 82-year-old man is brought to the emergency department with confusion and decreased level of consciousness. He is noted to be hypotensive, bradycardic, hypothermic, and hypoglycemic. The following ECG is…

Weekly Workout November 6, 2022

Literature Review: 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department Highlights

A 60-year-old man is brought into the emergency department by EMS for acute onset chest pain and diaphoresis concerning for an acute coronary syndrome. The following ECG is obtained on…

Weekly Workout October 23, 2022

ECG Basics and Fundamentals: the earliest evidence of cardiac ischemia on the ECG and when to obtain serial ECGs

A 68-year-old man is brought into the emergency department for acute chest pain radiating to the back. He appears very uncomfortable and is hypertensive on arrival. A CT angiogram is…

Weekly Workout May 15, 2022

ECG Basics and Fundamentals: PR segment or TP? the isoelectric baseline you should use to measure ST segment deviation

A 45-year-old woman presents to the ED with severe chest pain. She is minimally cooperative when trying to obtain a history and is requesting pain medication for severe pain. Physical…

Weekly Workout May 1, 2022

STAT ECG Diagnoses: findings of occlusion MI in patients with right bundle branch block (RBBB)

A 51-year-old man presents to the emergency department with acute chest pain and shortness of breath. The following ECG is obtained with no priors available for comparison:

Weekly Workout April 17, 2022

STAT ECG Diagnoses: what to do when the ST segment elevation in presumed STEMI resolves before patients get to the cath lab?

A 62-year-old woman is brought to the ED with severe chest pain radiating to the left shoulder. Pain is associated with shortness of breath, nausea, and diaphoresis. The following ECGs…

Weekly Workout March 27, 2022

STAT ECG Diagnoses: using ectopy and premature ventricular contractions (PVCs) to diagnose occlusion MI

A 62-year-old woman is brought to the ED by EMS with severe chest pain, shortness of breath, nausea, and diaphoresis. The following EMS ECG was obtained:

Weekly Workout November 29, 2021

STAT ECG Diagnoses: antiarrhythmic considerations in patients with unstable irregular tachydysrrhythmias

A 29-year-old male with no significant known PMHx presents to the ED with palpitations. He is found to be markedly tachycardic on arrival. The following ECG is obtained:

Weekly Workout November 22, 2021

Literature Review: diagnosis of acute coronary occlusion myocardial infarction in patients with ventricular paced rhythms

A 65-year-old woman presents to the ED with chest pain and diaphoresis concerning for an acute coronary syndrome. The following ECG is obtained:

Weekly Workout November 15, 2021

STAT ECG Diagnoses: the basics of left bundle branch blocks (LBBB) and how to identify occlusion MI in these patients

A 65-year-old man presents to the ED with chest pain and diaphoresis concerning for an acute coronary syndrome. The following ECG is obtained:

Weekly Workout November 8, 2021

STAT ECG Diagnoses: any ST segment elevation in patients with right bundle branch blocks (RBBB) is abnormal!

HPI: A 70-year-old male with PMHx of HTN, DM, CKD, and CAD is brought to the emergency department with chest pain and shortness of breath. The following ECG is obtained…

Weekly Workout October 4, 2021

STAT ECG Diagnoses: the ECG in patients with significant left ventricular hypertrophy (LVH) and how to identify occlusion MI in these patients (part 2/2)

LVH with strain pattern may mimic anterior coronary occlusion and is known to be a common cause of “false-positive” cath lab activations. The following prehospital ECGs were obtained in patients…

Weekly Workout September 27, 2021

STAT ECG Diagnoses: the ECG in patients with significant left ventricular hypertrophy (LVH) and how to identify occlusion MI in these patients (part 1/2)