OMI: STEMI & Beyond
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STAT ECG Diagnoses: the ECG in patients with significant left ventricular hypertrophy (LVH) and how to identify occlusion MI in these patients (part 1/2)
LVH with strain pattern may mimic anterior coronary occlusion and is known to be a common cause of “false-positive” cath lab activations. The following prehospital ECGs were obtained in patients…
Literature Review: cardiac risk factors and the risk of myocardial infarction (MI) in habitual marijuana use
A 25-year-old male is brought into the ED by EMS with acute onset chest pain. He has no significant past medical history or known cardiac risk factors but reports smoking…
ECG Basics and Fundamentals: the isoelectric baseline used to evaluate ST segment deviation
A 45-year-old woman presents to the ED with severe chest pain. She is minimally cooperative when trying to obtain a history and is requesting pain medication for severe pain. Physical…
STAT ECG Diagnoses: is this ST segment elevation due to early repolarization or a large STEMI?
A 38-year-old male presents to the ED with acute chest pain. The following ECG is obtained:
ECG Basics and Fundamentals: the basics of left bundle branch block (LBBB) and how to diagnose acute coronary occlusion myocardial infarction in these patients
A 65-year-old man presents to the ED with chest pain and diaphoresis concerning for an acute coronary syndrome. The following ECG is obtained:
Literature Review: subtle early signs of cardiac ischemia and the value of serial ECGs in patients being evaluated for acute coronary syndromes (ACS)
A 47-year-old man is brought to the ED by EMS for acute onset left sided chest pain. The history is concerning for an acute coronary syndrome. The following ECG was…
STAT ECG Diagnoses: the challenge of evaluating for occlusion MI in patients with left ventricular hypertrophy (LVH)
A 59-year-old man presents to the ED with intermittent exertional chest pain for the past 2 days. The following ECG is obtained:
STAT ECG Diagnoses: left bundle branch block (LBBB) basics and expected findings with a focus on how to diagnose acute coronary occlusion myocardial infarction in these patients
A 85-year-old woman with a known history of LBBB presents to the ED with chest pain concerning for acute ischemia. The following ECG is obtained:
Literature Review: evaluation of Spodick’s sign and other electrocardiographic findings as indicators of STEMI and acute pericarditis
A 40-year-old male presents to the ED with chest pain. The following ECG is obtained with a computer interpretation of “Acute Pericarditis”:
STAT ECG Diagnoses: diagnosis of acute myocardial infarction (MI) in patients with paced rhythms
An 86-year-old female with PMHx of CAD and pacemaker placement presents to the ED with acute chest pain. Pain has been radiating to the right upper extremity for 1 hour…
STAT ECG Diagnoses: are you activating the cath lab for a large STEMI or is this just early repolarization
A 50-year-old man presents with intermittent increasing epigastric discomfort. The following ECG is obtained:
ECG Basics & Fundamentals: how reliable are reciprocal changes in the diagnosis of STEMI and identication of acute coronary occlusion MI?
A 35-year-old man is brought into the ED by ambulance for chest pain. The following prehospital ECG is obtained:
STAT ECG Diagnoses: arrhythmias after thrombolysis for myocardial infarction (MI)
An 86-year-old man presents to the ED with substernal chest pressure, diaphoresis, and vomiting. The following ECG is obtained:
Literature Review: indications for acute reperfusion therapy in patients with symptoms of an acute coronary syndrome
You are taking care of a patient who presents to the ED with chest pain and symptoms concerning for ACS.
Literature Review: modified Sgarbossa criteria in the diagnosis of acute coronary occlusion MI in LBBB
An elderly patient with a history of CAD and a known LBBB presents to the ED with acute onset of chest pain. The following ECG is obtained:
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:
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