OMI: STEMI & Beyond
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Literature Review: modified Sgarbossa criteria in the diagnosis of acute coronary occlusion MI in paced rhythms
A 81-year-old male with PMHx of HTN and CAD s/p pacemaker insertion, presents to the ED complaining of chest pain radiating down both arms x 1 hour. He reports improvement…
ECG Basics & Fundamentals: normal and expected findings in right bundle branch block (RBBB) vs patients with occlusion MI
A 61-year-old male with PMHx of atrial fibrillation on anticoagulation presents to the ED with chest pain for 1 day after eating beef stew. He is concerned about having bad…
Differential Diagnoses: factors that rule in STEMI in the evaluation of diffuse ST segment elevation
A 60-year-old male presents to the ED with chest pain and mild dyspnea. The following ECG is obtained:
ECG Basics and Fundamentals: expected ECG findings in right ventricular (RV) paced rhythms
A 71-year-old male with PMHx of hypertension and pacemaker placement presents to the ED with chest pain, nausea, diaphoresis, and shortness of breath. The following ECG is obtained:
STAT ECG Diagnoses: does the presence of a LBBB obviate the ability to diagnose occlusion MI?
A 48-year-old man presents with 90 minutes of chest pain. He is hemodynamically stable and has a normal first troponin. The following ECG is obtained:
Differential Diagnoses: terminal QRS distortion in the differentiation of STEMI from early repolarization
A 43-year-old male presents to the emergency department with chest pain. The following ECG is obtained:
Literature Review: occlusion MI in paced rhythms
HPI: An 84-year-old male presents to the emergency department with 4 hours of chest pain. He has a history of coronary artery disease and has a pacemaker. The following ECG…
Literature Review: 2018 STEMI & STEMI equivalent guideline updates (Part 3/3)
A 80-year-old man presents to the ED with midsternal chest pain concerning for an acute coronary syndrome. The following ECG is obtained:
Literature Review: 2018 STEMI & STEMI equivalent guideline updates (Part 2/3)
A 60-year-old woman presents to the ED with midsternal chest pain concerning for an acute coronary syndrome. The following ECG is obtained:
Literature Review: 2018 STEMI & STEMI equivalent guideline updates (Part 1/3)
A 50-year-old man presents to the ED with midsternal chest pain concerning for an acute coronary syndrome. The following ECG is obtained:
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…
Differential Diagnosis: STEMI vs. acute pericarditis
A 45-year-old male presents to the emergency department with sharp, positional, and pleuritic chest pain while doing CrossFit. He is not a smoker and has no known cardiac risk factors….
Literature Review: classic STEMI criteria, and the cardiovascular effects of Marijuana
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 following…
Post-cardiac arrest ECGs: which arrest survivors should get emergent reperfusion therapy?
A 65-year-old man presents to the ED with substernal chest pain that radiated to the back and is associated with nausea. An ECG is obtained on arrival and is interpreted…
Differential Diagnoses: when STEMIs can present with right axis deviation
HPI: A 57-year-old with PMHx of HTN and cigarette smoking presents to the ED with chest pain and dyspnea. The following ECG is obtained: Case ECG Before watching this week’s…
Differential Diagnoses: diffuse ST segment elevation with a focus on left ventricular (LV) aneurysm
HPI: An elderly gentleman presents to the ED with diarrhea. He has no chest pain or dyspnea, and denies nausea or vomiting. He appears well. The following ECG was obtained…
STAT ECG Diagnoses: “Shark fin STEMI” morphology and what this ECG pattern means!
HPI: A 59-year-old male presents to the ED with exertional chest pain that resolved on arrival. An ECG (#1) is obtained at triage. While being interviewed by the physician who…
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: 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….
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:
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