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Cardiac arrest: even after the angiogram, the diagnosis is not always clear by Stephen Smith Posted in: Blog Posts in Heart Health A woman in her 40's who was healthy, except for hypertension, was at work when she suddenly complained of neck and shoulder pain and then collapsed.  It was witnessed, and ... Read on »
Missed myocardial infarction with subsequent cardiac arrest by Stephen Smith Posted in: Blog Posts in Heart Health A 50 year old male presented to his physician's office with "heartburn".  The physician recorded this ECG, interpreted it as normal, and sent the patient home on an antaci ... Read on »
Middle Aged Woman with Asystolic Cardiac Arrest, Resuscitated: Cath Lab? by Stephen Smith Posted in: Blog Posts in Heart Health A middle-age woman with h/o hypertension was found down by her husband.  Medics found her apneic and pulseless, began CPR, and she was found to be in asystole.  With venti ... Read on »
K. Wang Video: Differential Diagnosis of a Variety of Conditions (37 minutes)..... by Stephen Smith Posted in: Blog Posts in Heart Health Regular Narrow QRS tachycardia Regular Narrow QRS bradycardia Pauses Paired QRS Changing QRS Morphology ST Elevation in the Precordial Leads Read on »
Polymorphic Ventricular Tachycardia by Stephen Smith Posted in: Blog Posts in Heart Health A woman in her 40's presented with multiple "spells" in the past week, with increasing frequency.  She feels lightheaded, then becomes unresponsive.  It usually lasts abou ... Read on »
Atrial Flutter with Inferior STEMI? by Stephen Smith Posted in: Blog Posts in Heart Health A 40-something year old male presented with tachycardia. Computer analysis: Atrial Flutter with Inferior ST Elevation MI. The computer (and physician ... Read on »
K. Wang Video: Differential Diagnosis of Various ECG Findings (35 minutes) by Stephen Smith Posted in: Blog Posts in Heart Health Dr. Wang found some slight errors and will re-record this.  It will be re-posted when corrected.  Very sorry for the inconvenience!  I will announce when it is back up! ... Read on »
Terminal QRS Distortion due to LAD Occlusion by Stephen Smith Posted in: Blog Posts in Heart Health  A male in his 30's presented with chest pain. Here is his initial ECG   There is sinus rhythm, with a normal QRS and precordial ST elevat ... Read on »
Epigastric pain, Syncope, and Saddleback ST Elevation by Stephen Smith Posted in: Blog Posts in Heart Health A male in his 30's who is an elite athlete with no risk factors for coronary disease had brief epigastric pain followed by brief syncope.  He presented to the ED never hav ... Read on »
Right Bundle Branch Block with ST elevation in V2, V3. Why? by Stephen Smith Posted in: Blog Posts in Heart Health This young male patient had a very atypical presentation for STEMI (near syncope and abdominal pain after smoking an unknown drug), but we can pretend that it was not atyp ... Read on »
Two interrupted sinus beats. What is the etiology? by Stephen Smith Posted in: Blog Posts in Heart Health Thanks to our electrophysiologist, Rehan Karim, and to Dr. Wang for their assistance in this case. This is from a young person with palpitations, on no medications, an ... Read on »
Male in his 50's with chest discomfort by Stephen Smith Posted in: Blog Posts in Heart Health A male in his 50's with a history of type I DM was riding his bike to work when he developed squeezing chest pressure and a sensation that "something wasn't right."   He r ... Read on »
Chest pain and Bradycardia by Stephen Smith Posted in: Blog Posts in Heart Health An elderly male complained of chest pain.  He had no previous cardiac history and was only on aspirin, a statin, and a proton pump inhibitor. He was hypotensive but in no ... Read on »
A 20-something with palpitations and dizziness. What action will you take? by Stephen Smith Posted in: Blog Posts in Heart Health I have posted on this topic before, but whenever I think that readers completely understand it, I find there are still many who do not.  So I think it is worth the repet ... Read on »
Pseudo Type II Second Degree AV Block Induced by Concealed Premature Junctional Complexes (PJCs)... by Stephen Smith Posted in: Blog Posts in Heart Health This patient is running on a treadmill Figure 1. There are frequent apparently non-conducted p-waves.  The PR interval is not lengthening, so this is not AV W ... Read on »
Instructions for using subtleSTEMI iPhone app by Stephen Smith Posted in: Blog Posts in Heart Health Some have asked for instructions in using the app: 1.      The warning states that it should only be used when the differential  diagnosis is normal variant ... Read on »