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Is This a Simple Paced Rhythm? by Stephen Smith Posted in: Blog Posts in Heart Health A very complex patient presented critically ill.  This was his initial ECG There are pacer spikes.  Is this a simple paced rhythm? ... Read on »
Complaint of Weakness. Alert. Hemodynamically Stable. What is it? by Stephen Smith Posted in: Blog Posts in Heart Health A male in his 60's, dialysis patient, complained of weakness.  He was alert and had no SOB or Chest pain.  BP was 85/57 with a pulse of 65.  Here is his ECG W ... Read on »
ST Elevation and a Positive Troponin: Is it Myopericarditis or STEMI? by Stephen Smith Posted in: Blog Posts in Heart Health A 51 yo male smoker with no other CV risk factors and no previous heart disease presented to a hospital without PCI capability complaining of 1.5-2 hours of sev ... Read on »
Dyspnea on Exertion and a Positive Troponin by Stephen Smith Posted in: Blog Posts in Heart Health A woman in her 50's complained of dyspnea on exertion for two days.  Her lungs were clear on exam.  Her first troponin I returned at 0.1 ng/mL (elevated, upper limit of no ... Read on »
Paroxysmal SVT (PSVT) that repeatedly recurs in spite of successful conversion with adenosine by Stephen Smith Posted in: Blog Posts in Heart Health An elderly male complained of dyspnea.  His pulse was regular at just under 150.  BP was 110/70.  There was no evidence of shock or pulmonary edema.  Here is his ED ECG ... Read on »
45 year old with chest pain by Stephen Smith Posted in: Blog Posts in Heart Health A 45-year-old male was in his usual state of health until three hours prior to arrival, when he developed left-sided chest pressure with radiation to the neck while walkin ... Read on »
5 hours of chest pain. How acute is the STEMI? by Stephen Smith Posted in: Blog Posts in Heart Health A male is his 30's with h/o HTN presented after 6 hours of chest pain.  The pain was crushing and substernal, associated with nausea, vomiting, and diaphoresis, radiating ... Read on »
Outstanding General Lecture on the ECG in Acute MI: 34 minutes by Dr. K. Wang. by Stephen Smith Posted in: Blog Posts in Heart Health ECG Manifestations of Myocardial Infarction from HQMedEd on Vimeo . cited previous videos Ta Wave (Atrial Repolarization Wave), how it affects the ECG inter ... Read on »
P2Y12 Inhbitors in the ED for NonSTEMI. Criticisms of the ACCOAST-ed trial of Upstream vs.... by Stephen Smith Posted in: Blog Posts in Heart Health Rick Body had a nice piece in St. Emlyn's about the ACCOAST-ed trial, a study recently published in the NEJM on the use of Prasugrel in NonSTEMI: should it be given "upst ... Read on »
Look at the PVCs!! by Stephen Smith Posted in: Blog Posts in Heart Health An elderly woman presented with chest pain.  She was hemodynamically stable.  Here is her initial ECG There is bigeminy.  There is high voltage.  There is ST el ... Read on »
55 year old woman with chest pain and precordial T-wave Inversions by Stephen Smith Posted in: Blog Posts in Heart Health This 55 year old woman presented with chest pain There is sinus rhythm.  There is ST depression and there are negative T-waves in V1-V4. There is also STE in ... Read on »
Syncope and ST Segment Elevation. And another finding. How well does the computer interpretation... by Stephen Smith Posted in: Blog Posts in Heart Health A woman of approximately 50 years of age had been feeling weak and febrile, then had syncope.  EMS recorded this ECG Sinus Rhythm.  The ECG computer read "ST ... Read on »
ST Elevation and Positive Troponin. Is it STEMI? No. And it is not even ACS. by Stephen Smith Posted in: Blog Posts in Heart Health A male in his 60s complained of constant chest pain for 12 hours.  He has a h/o DM and HTN and has been off his meds, including clonidine, for 3 days.  His first two BP me ... Read on »
Low Voltage in Precordial Leads by Stephen Smith Posted in: Blog Posts in Heart Health A patient with was resuscitated from respiratory and cardiac arrest of uncertain etiology, but because she was very difficult to ventilate with BVM ventilation, and there ... Read on »
Ischemic Chest Pain and Hypertension: Use of Adjunctive Anti-ischemic Therapy by Stephen Smith Posted in: Blog Posts in Heart Health A middle aged male with several CAD risks has had several months of exertional angina relieved by rest and nitro.  He had the onset of chest discomfort at rest and present ... Read on »
Hyperacute T-waves? Anterior STEMI? No, LVH with PseudoSTEMI pattern! by Stephen Smith Posted in: Blog Posts in Heart Health There is sinus tachycardia.  There are very large anterior T-waves, with ST elevation.  However, there is also very high voltage.  Criteria for LVH is clearly ... Read on »
Is this Left Bundle Branch Block? Is there STEMI? by Stephen Smith Posted in: Blog Posts in Heart Health A male 1 ppd smoker in his 50's with no prior cardiac history called 911 because the chest pain and left arm pain, with SOB and diaphoresis,  He callled because the pain w ... Read on »
New Book Published by Dr. Wang: ECG Self-Study Book by Stephen Smith Posted in: Blog Posts in Heart Health http://www.amazon.com/ECG-Self-Study-Book-K-Wang/dp/9350909960 ECG Self-Study Book is a practical guide to help trainees interpret ECGs and recognize cardiac abnorma ... Read on »
31 Year Old Male with RUQ Pain and a History of Pericarditis. Submitted by a Med Student, with... by Stephen Smith Posted in: Blog Posts in Heart Health This was submitted by a fantastic medical student who wished to remain anonymous: A 31 year old male with a history of viral pericarditis one year ago pre ... Read on »