Dr. Smith's ECG Blog
DECEMBER 3, 2024
This was written by one of our fine residents, who will soon be an EMS fellow: Michael Perlmutter Case A mid-50s male came to the ED with a burning sensation that was acutely worse while at home. He came to the ED at the urging of his wife.
Dr. Smith's ECG Blog
JUNE 12, 2025
A 60-something with h/o Coronary Bypass called 911 for acute chest pain. On arrival, an ED ECG was recorded: Still diagnostic When a patient has severe chronic coronary disease, findings which appear to be acute can sometimes be chronic, so in this patient with h/o CABG (coronary bypass), it is wise to find a previous ECG if possible.
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JEMS
JULY 7, 2025
Rapid re-perfusion of the coronary arteries is essential to save at risk myocardium from infarction in patients with acute coronary artery occlusion. However, patients with occlusions that do not have STE may not activate the system and at least a quarter of the non-STEMI cases have an associated coronary artery occlusion.
Dr. Smith's ECG Blog
MAY 31, 2014
She then underwent a CT coronary angiogram : Coronary arteries: all normal, with calcium score of zero However, also seen: Bilateral pulmonary embolus seen in the bifurcation of the left pulmonary artery extending down into the descending branches and in the lingular branch. Right ventricular enlargement with probably reduced function.
Dr. Smith's ECG Blog
NOVEMBER 16, 2016
A middle-aged woman with known severe coronary disease had onset of substernal chest pain while at dialysis. A prehospital ECG was similar to the first ED ECG, which is shown below. Here is her initial ED 12-lead ECG: There is atrial fibrillation with a rate of approximately 114. Is this Acute Coronary Syndrome?
Dr. Smith's ECG Blog
AUGUST 30, 2015
He was sure the doctors did not tell him that his brother succumbed to occlusion in the coronary arteries. Here is his ED ECG: Day 1, "Hampir Stroke," temp 39 degrees : What do you see? His elder brother died 5 years ago, at the age of 38 years of similar “Hampir Stroke” symptoms. This is Classic Type I Brugada Morphology.
Dr. Smith's ECG Blog
DECEMBER 6, 2024
Angiogram: Severe two-vessel coronary artery disease of a left dominant system including 70 to 80% stenosis involving the distal left main/bifurcation. How many patients do not present to the ED until the next day? The estimated left ventricular ejection fraction is 64%. There is no left ventricular wall motion abnormality identified.
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