OMI: STEMI & Beyond
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Interesting Cases from UMMC (2024 – Part I/III)
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…
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:
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…
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: must know ECG patterns in screening for acute coronary occlusion
A 58-year-old woman is brought into the emergency department by paramedics with chest pain and diaphoresis. The following EMS ECG was obtained:
STAT ECG Diagnoses: early ECG signs of cardiac ischemia and acute coronary occlusion
A 72-year-old woman is brought to the emergency department by EMS with acute chest pain and shortness of breath. The following ECG is obtained on arrival:
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…
STAT ECG Diagnoses: how to identify acute coronary occlusion MI in patients with LVH with strain pattern
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:
Literature Review: STEMI vs. acute pericarditis
A 44-year-old man with no significant past medical history presents to the emergency department with chest pain. The following ECG is obtained:
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…
STAT ECG Diagnoses: causes of right axis deviation, and evaluation of ST segments in patient with right bundle branch block (RBBB)
An 80-year-old man presents to an emergency department in Chile with chest pain radiating to the right shoulder and back. The following ECG is obtained on arrival and computer interpreted…
ECG Basics and Fundamentals: subtle early signs of acute cardiac ischemia
A 57-year-old man presents to the emergency department with chest pain concerning for MI. The following ECG is obtained with no prior ECGs available for comparison. Cardiology is contacted and…
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:
Differential Diagnoses: findings of occlusion MI in patients with right bundle branch block (RBBB), prolonged QT intervals, and so much more!
A 64-year-old man with history of pulmonary embolism (on apixaban) presents to the ED with shortness of breath and lower extremity edema. He also reports mild headache and is noted…
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…
STAT ECG Diagnoses: can you have a STEMI without any ST segment elevation on the 12 lead ECG?
A 43-year-old woman is brought to the ED with chest pain and diaphoresis concerning for an acute coronary syndrome. The following ECG is obtained:
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:
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