Chest Pain
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Aslanger’s Pattern and the Limits of Traditional STEMI Criteria
A 76-year-old man presents to the emergency department with shortness of breath, severe weakness, diaphoresis, and confusion. The following ECG is obtained on arrival:
2025 Clinical Guidelines for the Management of Acute Coronary Syndromes: Key Highlights
A 90-year-old woman presents to the emergency department with acute chest pain, nausea, and shortness of breath. She has two negative troponins 6 hours apart. The following ECG was obtained…
Concordance vs. Discordance: Recognition of Critical ECG Patterns
A 54-year-old woman presents to the emergency department with acute chest pain radiating to the jaw and left upper extremity. The following ECG is obtained:
Respect the T Wave: Early Clues to Cardiac Ischemia
A 54-year-old man presents to the emergency department with chest pain concerning for an acute coronary syndrome. An initial ECG is performed on arrival and appears normal, the following repeat…
2024 UMMC Cases (Part II)
A 55-year-old woman arrives at the emergency department with shortness of breath and is noted to be tachypneic. The following ECG is obtained:
The Approach to Uncovering Hidden STEMI
A 92-year-old man presents to the emergency department with acute chest pain and diaphoresis. The following ECG is obtained:
Timeless ECG Lessons: Revisiting Classic Cases and Life Saving Interpretations
A 37-year-old man with no significant past medical history presents to the emergency department with acute chest pain and shortness of breath after a meal. He suspects he is having…
Recent UMMC Cases
A 67 -year-old man presents to a busy emergency department with acute chest pain and shortness of breath. The following ECG is obtained, but he leaves without being seen because…
Concerning chest pain with ST segment depression in the anteroseptal leads (Part 1/2)
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…
Subtle ECG Changes and Diagnostic Challenges
A 70-year-old male presents to the emergency department with acute chest pain that sounds ischemic in nature. The following baseline ECG, arrival ECG, and repeat ECGs are obtained:
Literature Review: ST segment elevation, but not in contiguous leads!
A 57-year-old woman presents with chest pain and dyspnea. She is hemodynamically stable and her exam is non-diagnostic. The following ECG is obtained:
2024 EMS Cases Part I
A 64-year-old man is being brought in by EMS for chest pain and shortness of breath. The following EMS ECG is obtained:
STAT ECG Diagnoses: important considerations in hypotensive patients with acute cardiac ischemia
A 59-year-old man with no significant past medical history presents to the emergency department with chest pain, nausea, and shortness of breath for 1 hour. He appears diaphoretic on arrival…
STAT ECG Diagnoses: distinguishing STEMI from pericarditis, and the difference between Wellens waves and Wellens syndrome
A 54-year-old man presents to the emergency department with acute sharp chest pain that is positional and pleuritic. The following ECG is obtained:
STAT ECG Diagnoses: are ECG abnormalities necessary for the diagnosis of acute pericarditis?
Two separate 50-year-old men present to the emergency department with chest pain. Pain in both patients is described as sharp, pleuritic, and positional. The following ECGs are obtained:
ECG Basics & Fundamentals: new tall upright T waves in lead V1
A 53-year-old woman with PMHx of HTN and DM presents with atypical chest pain. She is noted to have a completely normal baseline ECG. The following ECG is obtained:
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…
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:
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:
ECG Basics & Fundamentals: dynamic ischemic ECG changes in ACS
A 41-year-old male with no past medical history is brought into the ED with bilateral shoulder pain that has been intermittent throughout the day. On arrival the pain is mild,…
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