OMI: STEMI & Beyond

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…

2025 EMS Cases Part II

A 57-year-old man is being brought in by EMS for generalized weakness and vomiting. The following ECG is obtained and transmitted as a CODE STEMI alert:

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…

Hyperacute T Waves: Distinguishing Early MI from Other Big T Wave Abnormalities

A 64-year-old man with PMHx of HTN, DM, and tobacco use presents with central chest pain that radiates to his left arm. The following ECG is obtained on arrival:

2024 UMMC Cases (Part III)

A 67-year-old man arrives at the emergency department with palpitations. He is noted to be tachycardic at triage and the following ECG is obtained and interpreted as “sinus tachycardia”:

2024 UMMC Cases (Part I)

A 69-year-old man arrives at the emergency department with shortness of breath and profuse sweating. The ECG obtained below shows sinus tachycardia at a rate of ~ 130 bpm with…

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:

Is This a STEMI or STEMI Equivalent Pattern?

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…

Biphasic T Waves in Suspected Acute Coronary Syndrome

A 69-year-old man with PMHx of hypertension and polysubstance abuse presents to the emergency department for evaluation of exertional chest pain that resolves with rest. He is currently asymptomatic. The…

Cardiovascular Effects of Cannabis Use

A 32-year-old woman presents to the emergency department with gradually worsening chest pain throughout the day. She has no significant medical history and no known cardiac risk factors. She reports…

AI Advances in ECG Interpretation: Why Human Expertise Still Matters

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…

2024 EMS Cases Part IV

A 60-year-old man is being transported by EMS to the emergency department for acute chest pain. The following ECG is transmitted prior to arrival as a “CODE STEMI” and brought…

Concerning chest pain with ST segment depression in the anteroseptal leads (Part 2/2)

A 50-year-old woman presents to the emergency department with acute chest pain. The following ECG is obtained on arrival:

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:

2024 ECG Competition Answers (Part 2/2)

Instructions from Dr. Mattu: In some of the following questions, I’ll ask you for a FULL ECG interpretation/diagnosis. Here’s what I am asking for: SAMPLE QUESTION: A 58 yo M…

2024 ECG Competition Answers (Part 1/2)

Instructions from Dr. Mattu: In some of the following questions, I’ll ask you for a FULL ECG interpretation/diagnosis. Here’s what I am asking for: SAMPLE QUESTION: A 58 yo M…