Dr. Smith's ECG Blog

MAY 20, 2024

A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon. Edited by Smith He also sent me this great case.

CAD 132

CAD STEMI Coronary ACS 132

Dr. Smith's ECG Blog

MARCH 19, 2024

The patient presented to an outside hospital An 80yo female per triage “patient presents with chest pain, also hurts to breathe” PMH: CAD, s/p stent placement, CHF, atrial fibrillation, pacemaker (placed 1 month earlier), LBBB. This case was sent by Amandeep (Deep) Singh at Highland Hospital, part of Alameda Health System.

CAD 118

CAD STEMI ACS ALS 118

Dr. Smith's ECG Blog

APRIL 4, 2011

Because if such severe CAD is present, the patient is likely to need CABG. They show that if there is not >/= 1 mm STE in aVR, then ACS is highly unlikely to be due to severe 3-Vessel disease or Left Main. why is this important? If they need CABG, then the surgeon will usually be unhappy if the patient received clopidogrel.

CAD 52

CAD ACS Coronary ALS 52

Dr. Smith's ECG Blog

JANUARY 6, 2016

consult: In summary, this is a 47 year old male with past medical history of CAD s/p STEMI in 2010 s/p PCI to LAD with BMS, HTN, tobacco, alcohol and substance abuse that presented with chest pain and found to have ST elevation with T wave inversion in his ECG. Patient had blood cultures drawn.

CAD 52

CAD ACS ICU STEMI 52

Core EM

DECEMBER 1, 2023

Metoprolol Considerations: Dosing (5 mg every 10-15 minutes, max 15 mg), benefits in CAD and HF, limitations in asthma/COPD patients. Treatment Approaches for AF Types General Rapid AF: First Line Agents: Metoprolol vs. Diltiazem. Diltiazem Advantages: Faster action, suitability in asthma/COPD, typical dosing (0.25 mg/kg if needed).

CAD 130

CAD OR 130

Dr. Smith's ECG Blog

JUNE 19, 2015

A patient with history of severe CAD, CABG, with all native vessels occluded, on maximal medical therapy presented with his typical angina. NSTEMI: Patient with known severe CAD presenting with troponin elevation up to 21 and chest pain that was refractory to initial nitroglycerin therapy suggestive of unstable angina.

CAD 52

CAD Coronary OR 52

Dr. Smith's ECG Blog

FEBRUARY 12, 2024

This is for the version housed on Telegram: [link] You can get the full PM Cardio app here if you live in the UK or EU (or say you do upon registration): [link] Case Continued The cath lab was activated and the patient received 180 mg of ticagrelor, and then was transported to the cath lab.

CAD 109

CAD ED OR Coronary 109

Dr. Smith's ECG Blog

APRIL 9, 2024

By Magnus Nossen This ECG is from a young man with no risk factors for CAD, he presented with chest pain. Before the lab values returned this patient had a n emergent coronary CT angiogram done that ruled out CAD. How would you assess this ECG? How confident are you in your assessment? What is your next step?

Coronary 113

Coronary CAD ACS OR 113

FirstNet Authority

JANUARY 26, 2024

In 2002, Jennifer transitioned to the Broomfield Police Department in Colorado where she dispatched and served as an Emergency Medical Coordinator, Communications Training Officer, Public Education Coordinator, and Computer-Aided Dispatch (CAD) Project Lead.

CAD 52

CAD Public Safety Public Information First Responder 52

The Skeptics' Guide to EM

JULY 2, 2022

Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? AEM June 2022.

Coronary 100

Coronary Heart Attack ACS CAD 100

ESO

SEPTEMBER 5, 2024

With API , participating CAD and RMS vendors will be able to automatically send data back and forth to NERIS. For any CAD and RMS vendors who are interested, you can share information and ask questions during the USFA development tea m’s regular NERIS office hours.

CAD 59

CAD PSAP Mobile Integrated Health Community Paramedicine 59

NVFC

JULY 16, 2024

Once the new system is in place, it will also be able to integrate information from the computer-aided dispatch system (CADS). Implementation and Benefits NERIS will require a significant update to the current records management system software, or alternatively, the use of a new free app for collecting incident data.

Firefighter 105

Firefighter CAD Emergency Response OR 105

FirstWatch

AUGUST 2, 2023

With FirstWatch, I get alerted through CAD triggers on my phone as soon as that call comes through. Having instant access to CAD data allows me to do this.” Lay of the Land It’s not just the CAD data the chief appreciates. “I PD continues to innovate, despite staffing challenges Chief Jeffrey Beazizo of the Lake Stevens, Wash.,

CAD 52

CAD 52

Dr. Smith's ECG Blog

OCTOBER 1, 2023

A man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. This is a re-post of an excellent case from 2021. See it again now, along with our new Queen of Hearts functionality. We've come a long way in 2 years! And the pace only quickens.

OR 134

OR STEMI CAD Coronary 134

ESO

OCTOBER 1, 2024

We hope to have a basic NERIS-compliant beta early in 2025, with additional updates (CAD imports, ESO EHR integration, ESO Insights reporting, etc.) It will be a simplified version and may not yet be ideal for agencies with ESO suite integrations like CAD and EHR imports. The timeline may vary.

CAD 59

CAD Public Safety First Responder OR 59

EMS 12-Lead

JUNE 20, 2022

Moreover, he had no pertinent medical history to report in terms of CAD, HTN, HLD, or DM, for example. CASE 1 A 45 y/o Male called 911 for new onset central chest discomfort, non-radiating, 5/10 pain scale, and without any vomiting, diaphoresis, or pallor. A 12 Lead ECG was recorded.

ACS 130

ACS Coronary CAD STEMI 130

High Performance EMS

JANUARY 26, 2021

Your existing historical CAD records contain the necessary information to build such dynamic views in real-time. The existence of identifiable causes explains the ability to properly forecast the vicinity of calls in addition to their timing.

CAD 100

CAD Emergency Response Emergency Medical Services Ambulance 100

International Journal of Paramedicine

JULY 8, 2024

This included date, POE, patient demographics, chief complaint, computer-aided dispatch (CAD), provider impression (diagnosis), and time out of service. The El Paso Fire Department (EPFD) provided data for all encounters between February 2017 and January 2023.

Prehospital Care Provider 52

Prehospital Care Provider CAD Emergency Medical Services EMS 52

EMS 12-Lead

JULY 24, 2023

These concerns were readily conveyed to my supervising cardiologist with particular emphasis on high pretest probability for baseline advanced CAD (3-vessel disease, specifically) with a critically stenosed proximal LAD. A quick way to validate this conjecture is to simply acquire a secondary ECG, but I failed to do this in the moment.

Coronary 130

Coronary ACS CAD ED 130

Dr. Smith's ECG Blog

APRIL 14, 2023

Sent by Anonymous, written by Pendell Meyers A man in his 60s with history of CAD and 2 prior stents presented to the ED complaining of acute heavy substernal chest pain that began while eating breakfast about an hour ago, and had been persistent since then, despite EMS administering aspirin and nitroglycerin. Pre-intervention.

CAD 52

CAD ACS STEMI Coronary 52

Dr. Smith's ECG Blog

OCTOBER 24, 2019

However, a smooth tapering of the mid-RCA was seen, highlighted in red below: How do we explain the MI if no sign of CAD was found? This MI wasn’t caused by a ruptured plaque of CAD - it was a coronary artery dissection of the RCA. This case occurred 10+ years ago. Excellent description by Dr.

CAD 52

CAD Coronary ACS STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 22, 2023

Patient stated that he has had glucose over 400 even though he has not missed any doses of insulin.

ED 125

ED Coronary CAD STEMI 125

Dr. Smith's ECG Blog

JANUARY 16, 2025

Transferred to our ED and taken to cath lab Cath- mild nonobstructive CAD, mild mid LAD bridge Echo- EF 65-70%, normal wall motion, no diastolic dysfunction. "Feels like a fake to me, but would be an awful miss so I would be very careful 4. STE from lead I all the way around to lead III would be pretty unusual for OMI, I guess."

CAD 52

CAD ACS STEMI ED 52

FirstWatch

JUNE 18, 2024

During this engaging session, we will explore cutting-edge technology that EMS systems use to tackle this problem in near real-time.

Overdose 40

Overdose CAD Emergency Medical Services EMS 40

Dr. Smith's ECG Blog

JUNE 29, 2018

Angiogram The patient did go for an angiogram and there was no occlusion present, and no definite culprit, although there was diffuse CAD and one possible culprit: "There is a medium-large caliber OM3 with 40-50% stenosis in the mid-segment and lumen irregularity that could suggest dissection or plaque rupture, but TIMI III flow throughout."

CAD 52

CAD Coronary OR 52

Dr. Smith's ECG Blog

DECEMBER 6, 2010

He had no previous history of CAD, and presented with very typical waxing and waning chest pain, much worse with exertion but also present at rest and on presentation, though his pain was minimal at the time of the ECG. I saw this 59 year old male 3 weeks ago. Blood pressure was 150/80.

STEMI 52

STEMI CAD OR 52

Dr. Smith's ECG Blog

JUNE 1, 2012

This was a middle aged female with a h/o CAD who presented to the ED by EMS sudden onset of central chest pressure 45 min prior to ED arrival with associated diaphoresis and SOB.  There is LVH and there are ST-T abnormalities (large inferior T-waves and ST elevation, with reciprocal findings in aVL).

STEMI 52

STEMI CAD ED EMS 52

Dr. Smith's ECG Blog

SEPTEMBER 4, 2023

Multivessel coronary artery disease --severe 3v CAD --subtotal occlusion mLAD with TIMI-1 flow --D1 subtotal occlusion --RCA 80% mid stenosis --Lcx OM2 ostial stenosis 70% Ischemic cardiomyopathy, LVEF 30% Acute decompensated heart failure Hypoxic respiratory failure, now resolved Here is an MRI image of the LV aneurysm.

CAD 52

CAD Coronary OR 52

Dr. Smith's ECG Blog

APRIL 24, 2015

He had a history of CAD with CABG. A middle-aged male had a V Fib arrest. He had not complained of any premonitory symptoms (which is very common). Here was his initial ED ECG: There is atrial fibrillation with a rapid ventricular response. There is profound ST depression especially in I, II, V2-V6.

Defibrillator 52

Defibrillator ACS CAD STEMI 52

Dr. Smith's ECG Blog

APRIL 18, 2024

Similarly, if a patient with known CAD presents with refractory ischemic chest pain, the ECG barely matters: the pre-test likelihood of acute coronary occlusion is so high that they need an emergent angiogram. 1] European guidelines add "regardless of biomarkers".

STEMI 127

STEMI Coronary ALS CAD 127

ESO

JULY 25, 2023

There are five NERIS Fire Data Standards currently in development today – they are: core fire data specification, CAD interface standard and API guide, incident, investigative, and exposure data standards. What are the milestones? NFIRS will remain operational throughout the completion and launch of the new NERIS system.

Emergency Response 52

Emergency Response CAD 52

Dr. Smith's ECG Blog

MAY 28, 2024

Multivessel CAD 2. The calculated post stress ejection fraction is 44%. Inferolateral/anterolateral/inferior akinesis noted. EKG reveals marked ST segment depression at rest and following stress. Cardiology consult impression 1. Ischemic cardiomyopathy, EF 45 --> 20% 3.

Coronary 52

Coronary CAD ACS STEMI 52

Dr. Smith's ECG Blog

MAY 19, 2020

Diagnosis of MINOCA should be made according to the Fourth Universal Definition of MI, in the absence of obstructive coronary artery disease (CAD) (no lesion ≥50%). The authors recommend using optical coherence tomography or intravascular ultrasound imaging in patients with evidence of nonobstructive CAD by angiogram. myocarditis).

Defibrillator 52

Defibrillator CPR Coronary CAD 52

Dr. Smith's ECG Blog

JANUARY 1, 2018

No known risk factors for ACS/CAD. A medic sent this case A 33 yom who presented to an urgent care facility with a complaint of chest pain for several days. His chest pain started after he began taking a testosterone supplement.

CAD 40

CAD ACS Paramedic OR 40

Emergency Medicine Ireland

DECEMBER 7, 2020

As the pregnant population continues to age and with RF and smoking and DM still common we can expect to see pregnant woman with CAD. Well, most commonly we’re going to see ACS. Pregnancy itself with its bump in plasma volume, reduced Hb and increased cardiac output is like one long exercise stress test.

Critical Care 40

Critical Care CAD Plasma ACS 40

Dr. Smith's ECG Blog

JANUARY 19, 2025

Inferior STEMI s/p DES with significant residual LM/left sided obstructive CAD : TnI 11,344 on admission, suggesting significant infarct prior to presentation. Subsequently, determined that the patient was too unstable for transfer in the current state. Hence, decision made to ECMO cannulation prior to transfer.

MICU 52

MICU ICU CAD STEMI 52

EMDocs

FEBRUARY 7, 2024

Increased risk in those with preexisting CKD, other risk factors for renal disease (HTN or CAD), and those on ACEIs/ARBs. AKI associated with GLP-1 agonist therapy is prerenal in nature and associated with nausea, vomiting, diarrhea, and reduced oral intake.

Allergic Reaction 95

Allergic Reaction ALS CAD OR 95