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

ESO

JULY 3, 2024

EHR | Critical Care We’ve expanded our Critical Care offering with the following web and Windows mobile additions: Flight Form Lab Values – CMP (Comprehensive Metabolic Panel) Ventilator Monitoring Adjustment However, that’s not all for Critical Care documentation! Be on the lookout for additional enhancements coming soon.

Mobile Integrated Health 52

Mobile Integrated Health MIH Critical Care Community Paramedicine 52

Dr. Smith's ECG Blog

MARCH 19, 2023

Concerning history, known CAD" Recorded 2 hours after pain onset: What do you think? To realize — Assessment of ECG #1 is complicated by knowing: i ) That today’s patient has a history of documented CAD ; and , ii ) The lack o f a prior tracing for comparison at the time the initial ECG was interpreted.

STEMI 52

STEMI Coronary CAD OR 52

ACEP Now

APRIL 4, 2024

This patient had known coronary artery disease (CAD), and previously required drug eluting stents to the obtuse marginal and diagonal arteries. However, the patient had known dextrocardia based on documented medical history and was confirmed with a recent chest x-ray.

Coronary 40

Coronary STEMI CAD Emergency Department 40

Dr. Smith's ECG Blog

JULY 3, 2018

Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. The pain initially started the day prior to presentation. The ejection fraction was 54% at that time.

ACS 52

ACS STEMI Coronary CAD 52

Dr. Smith's ECG Blog

JANUARY 31, 2020

Therefore, the “ m agical” r eciprocal r elationship seen between leads III and aVL with a cute i nferior O MI is not seen in ECG #1 ( See My Comment in the 1/29/2020 post , among many other references to this phenomenon in Dr. Smith’s blog ).

ED 52

ED Coronary ACS CAD 52

Dr. Smith's ECG Blog

JULY 22, 2023

The patient proceeded to cath where all coronaries were described as normal with no evidence of any CAD, spasm, or any other abnormality. Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon.

E-9-1-1 92

E-9-1-1 CAD STEMI OR 92

Dr. Smith's ECG Blog

JANUARY 30, 2019

A formal echocardiogram was completed the next day and again showed a normal ejection fraction without any focal wall motion abnormalities to suggest CAD. Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. There is no further workup at this time.

E-9-1-1 52

E-9-1-1 CAD STEMI Defibrillator 52

Dr. Smith's ECG Blog

APRIL 8, 2016

He had significant history of CAD with CABG x5, and repeat CABG x 2 as well as a subsequent PCI of the graft to the RCA (twice) and of the graft to the Diagonal. Document in the patient's chart that rapid infusion is intentional in response to life-threatening hypokalemia." A late middle-aged man presented with one hour of chest pain.

STEMI 52

STEMI Plasma Defibrillator OR 52

ECG & Echo Learning

JANUARY 18, 2023

IIa C During hospital stay (after primary PCI) Either stress echo, CMR, SPECT, or PET may be used to assess myocardial ischaemia and viability, including in multivessel CAD. I C During hospital stay (after primary PCI) When echocardiography is suboptimal/inconclusive, an alternative imaging method (CMR preferably) should be considered.

STEMI 40

STEMI Coronary Defibrillator OR 40

ESO

FEBRUARY 21, 2025

What began as a set of necessary features and functionality to support documentation requirements is now evolving to technology for the full patient care journey. Emergency service technology, across all markets and needs, is making a long-awaited shift. These updates come following the acquisition of Logis Dispatch and Billing solutions.

Mobile Integrated Health 59

Mobile Integrated Health MIH Community Paramedicine Critical Care 59

Dr. Smith's ECG Blog

JANUARY 15, 2025

Case A 68 year old man with a medical history of hypertension, hyperlipidemia, and CAD with stent deployment in the RCA presented to the emergency department with chest pain. He looked back in time in the patient's chart and saw these ECGs and immediately recognized that they manifested subtle OMI. He had an EKG recorded right away.

Coronary 73

Coronary ED CAD Paramedic 73

Dr. Smith's ECG Blog

DECEMBER 31, 2024

The note documents that the first view of the LCX showed 99%, TIMI 2 flow, but then (before intervention) was seen to fully occlude in real time (100%, TIMI 0). The procedure was described as very complex due to severe multivessel CAD, but ultimately PCI was successfully performed to the ostial LCX. Pre-intervention.

Coronary 125

Coronary ACS STEMI CAD 125

EMDocs

MAY 8, 2025

Family history includes CAD, hypertension, and diabetes. document your rationale. If you disagree, ask him/her to document the conversation. When the EP sees the patient 80 minutes after arrival, the patients chest pain and nausea are gone. Past history reveals high cholesterol, COPD and a recent negative cardiac stress test.

CAD 57

CAD EMT EMT ED 57

ESO

APRIL 29, 2025

Here are some key features to look out for: CAD & Cardiac Monitor Integration: The application supports integration with cardiac monitors and CAD systems, enhancing your ability to swiftly monitor and respond to patient needs. It’s as simple as saying, “Hey Siri, capture pulse rate in EHR.”

CAD 52

CAD MIH Defibrillator OR 52