STEMI

Literature Review: lumen stenosis doesn’t matter in ACS…It’s all about plaque vulnerability!

HPI: A 50-year-old male presents to the ED with concerning chest pain while driving home after an appointment with his cardiologist. He reports having an exercise stress test earlier in…

Several challenging EMS cases to help you make the diagnosis and save more lives!

A 44-year-old man with PMHx of diabetes is transported to the ED by EMS for lethargy and altered mental status. His finger stick blood glucose measurement read as “high”.  The…

Literature Review: outcomes for patients with STEMI presenting with nondiagnostic initial ECGs

A 45-year-old man presents to the ED with 1 hour of chest pain, shortness of breath, and diaphoresis. The following ECG is obtained:

EMS ECGs: ventricular tachycardia (VT) pearls and pitfalls

A 47-year-old woman is brought in by EMS with intermittent palpitations and lightheadedness. The following prehospital ECG was obtained:

2017 ECG Competition Answers (Part 2/2)

  This week we review the answers to questions 7-14 from the 5th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red box…

STAT ECG Diagnoses: new T wave inversion or ST segment depression in aVL

A 66-year-old man presents to the ED with retrosternal chest pain that is associated with nausea. The following ECG is obtained:

ECG Basics & Fundamentals: chest pain in young patient with no known cardiac risk factors

A 35-year-old man with no PMHx presents to the ED with dull burning chest pain that radiates to his left arm. The following ECG is obtained:

ECG Basics & Fundamentals: when a T wave inversion in lead aVL matters

A 45-year-old woman presents to the ED with severe heartburn. Her pain is associated with dyspnea and diaphoresis. The following ECG is obtained:

4 challenging EMS cases to help you nail the diagnosis

A 60-year-old male calls EMS for nausea and vomiting. He is found to be hypotensive in the field with a blood pressure of 75/40 mmHg. The following ECG is obtained:

Wide Complex Tachycardias: considerations in unstable patients with discussion on an important VT mimic

A 78-year-old woman called EMS for palpitations and mild chest pressure. She was shocked 4 times prior to arrival for a wide complex tachycardia and waxing and waning mental status…

Refractory ischemic chest pain despite maximal medical management

STAT ECG Diagnoses: differential for ST segment depression in the anteroseptal leads

A 36-year-old woman with a past medical history of rheumatoid arthritis presents to the ED with 3 days of waxing and waning chest tightness. The pain is pleuritic and 4/10…

STAT ECG Diagnoses: considerations in hypotensive STEMI patients

A 72-year-old woman presents to the ED by EMS with chest pain. She was noted to have normal vital signs and an unremarkable physical exam and given aspirin and nitroglycerin…

Literature in support of Sgarbossa criteria (Part 2/2)

 A 73-year-old man presents to the ED with acute chest pain and nausea. He has a history of heart disease and has a pacemaker. The following ECG is obtained:

Literature in support of Sgarbossa criteria (Part 1/2)

A 50-year-old man with a known left bundle branch block presents to the ED with acute chest pain. The following ECG is obtained:

EMS ECGs: differentials to consider when dealing with ST elevation and right axis deviation in sick patients

A 26-year-old man presents to the ED with chest pain. The following prehospital ECG is obtained:

Age as a cardiac risk factor

A 32-year-old woman presents to the ED with 2 hours of chest pain. She has a history of psychosis and smokes cigarettes. The following ECG is obtained:

ECG Basics & Fundamentals: when does the QRS complex end and the ST segment begin in RBBB

A 67-year-old woman with PMHx of Diabetes is brought in by ambulance for 2 hours of chest pain. At arrival she reports mild associated arm pain. The following ECG is…

ECG Basics & Fundamentals: diagnostic criteria for acute pericarditis

A 38-year-old man presents with mid-sternal, sharp chest pain. The pain is non-radiating, worse when supine, and is not associated with any diaphoresis or vomiting. The following ECG is done:

2016 ECG Competition Answers (Part 1/2)

This week we review the answers to the first 6 cases from the 4th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before you watch the video!  Video…