ACS

Results:
Weekly Workout January 7, 2019
ECG Basics & Fundamentals: respect the T waves!

A 29-year-old male presents to the emergency department with a mild headache and dyspnea. He is an avid cyclist who biked 40 miles the day before. His exam is normal….

Weekly Workout October 8, 2018
ECG Basics and Fundamentals: how many STEMI patients present with nondiagnostic initial ECGs?

HPI:  A 52-year-old male with PMHx of HTN & HLD presents to the ED with chest pain and shortness of breath. He looks uncomfortable on exam and is hypertensive. The…

Weekly Workout September 24, 2018
ECG Basics and Fundamentals: does negative troponin ACS still exist?

A 60-year-old male with PMHx of hyperlipidemia presents to the emergency department with midsternal chest pain (tightness), nausea, and diaphoresis. Symptoms have been intermittent, occur with walking and resolve with…

Weekly Workout August 6, 2018
How serial ECGs can save lives!

A 49-year-old man is brought in by EMS to the ED with chest pain concerning for cardiac ischemia. The following prehospital ECG was obtained:

Weekly Workout July 30, 2018
EMS ECGs: accelerated idioventricular rhythm (AIVR) in patients with ACS and other critical cases to help you save lives!

 A 69-year-old man is brought in by EMS to the ED with chest pain and shortness of breath. No prehospital treatment was rendered. The following prehospital ECG was obtained:

Weekly Workout July 23, 2018
EMS ECGs: respect lead aVL and looks for subtle early signs of cardiac ischemia

A 30-year-old woman is brought in by EMS to the ED with chest pain. The following prehospital ECG is obtained:

Weekly Workout June 11, 2018
STAT ECG Diagnoses: ECG findings that preceed ST segment elevation in acute coronary syndromes

A 70-year-old man presents to the ED with right sided chest pain that radiates to the left. His pain started while running to catch the subway, and is associated with…

Weekly Workout June 4, 2018
Literature Review: classic STEMI criteria, and the cardiovascular effects of Marijuana

HPI:  A 32-year-old man presents to the ED with chest tightness, nausea and dyspnea. He has no past medical history or cardiac risk factors, but reports smoking marijuana regularly. The…

Weekly Workout April 30, 2018
Loss of precordial T wave balance

HPI:  A 61-year-old woman presents to the ED with substernal chest pain and dyspnea. Her symptoms improve (but don’t resolve) with nitroglycerin. The following ECG is obtained, with no priors…

Weekly Workout April 9, 2018
Differential Diagnoses: considerations in patients with right axis deviation (RAD) and T wave inversions

HPI: An 86-year-old male with PMHx of MI, HTN, HLD, COPD, and CVA presents with abrupt onset chest pain, dyspnea, and nausea. Pain started a few hours ago, is non-radiating,…

Weekly Workout April 1, 2018
Risk stratification of acute coronary syndromes (ACS) and differential diagnoses for poor R wave progression

HPI:  A 54-year-old male smoker presents to the ED with intermittent left sided chest pain. Episodes last 5 minutes at a time and are associated with mild dyspnea on exertion….

Weekly Workout March 18, 2018
Literature Review: prevalence of acute coronary syndromes in your patients

HPI:  A 27-year-old male with PMHx of IDDM and heat exhaustion presents to the ED with bilateral arm cramping associated with chest and back aches after doing physical labor outdoors….

Weekly Workout February 12, 2018
ECG Basics & Fundamentals: can young patients have an MI?

HPI: 24-year-old male presents to the ED with chest pain. He has no known cardiac risk factors. Pain is constant for the past hour and he is noted to be…

Weekly Workout January 28, 2018
ECG Basics & Fundamentals: how frequently should you obtain serial ECGs in patients with concern for ACS

HPI: A 65-year-old patient is brought in by EMS for a chest pain history that is concerning for ACS. The following ECG is obtained: Case ECG Before watching this week’s…

Weekly Workout January 13, 2018
ECG Basics & Fundamentals: serial ECGs in a patient with chest pain and a paced rhythm

HPI: A 63-year-old male calls EMS after a syncopal episode. He is found to be alert, but complaining of chest pain that radiates bilaterally and that is associated with diaphoresis….

Weekly Workout January 8, 2018
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…

Weekly Workout October 16, 2017
Differential Diagnoses: ST segment elevation in aVR

A 74-year-old man presents to the ED for chest pain with exertion for the past 2 hours.  He appears diaphoretic and acutely ill. The following ECG is obtained:

Weekly Workout October 8, 2017
Literature Review: De Winter T waves

A 48-year-old man presents to the ED for chest pressure associated with diaphoresis while riding his bike. The following ECG is obtained during active chest pain:

Weekly Workout September 4, 2017
STAT ECG Diagnoses: earliest ECG findings of cardiac ischemia

A 78-year-old man is sent to the ED from a primary care clinic for chest pain. The following ECG is obtained:

Weekly Workout August 14, 2017
Literature Review: what do you do when ST-segment elevation in STEMI resolves before cath lab activation

A 49-year-old man presents with chest pain and diaphoresis while riding his bike. His ECG shows inferior and posterior STEMI. After aspirin and nitroglycerin, the patient’s symptoms resolve and the…

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