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ECG Cases 39 – Transient STEMI Pitfalls and Pearls
by Jesse McLaren
Jan 17, 2023
In this ECG Cases blog we look at 9 patients with possible transient STEMI and discuss pitfalls and pearls in ECG interpretation and management...
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Tactical Medicine News
ECG Cases 38 – ECG Interpretation in Cocaine Chest Pain
Dr. Jesse McLaren discusses some key aspects of cocaine chest pain ECG interpretation in this month's blog including: Patients with cocaine-associa...
Tactical Medicine News
ECG Cases 35 – ECG Approach to Takotsubo Syndrome
Takotsubo Syndrome is usually triggered by an emotional or physical stress leading to acute catecholaminergic myocardial stunning. The initial ST e...
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ECG Cases 34 – ECG Interpretation in Aortic Dissection
Which patients with ECG evidence of coronary occlusion require a CT scan to rule out aortic dissection? What are the range of ECG findings in acute...
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ECG Cases 32 Prehospital ECG pearls and pitfalls
In this ECG Cases blog we review 8 cases of patients with prehospital ECGs and explore prehospital ECGs for diagnosing STEMI, Occlusion MI, false S...
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ECG Cases 31 Is a 15 lead ECG better than 12? Diagnosing Posterior MI and RVMI
Is 15 lead ECG better than 12 lead for diagnosing posterior MI or right ventricular infarction? When do you need a 15 lead ECG? Jesse McLaren guide...
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ECG Cases 30 Beware Computer Interpretation Errors
Computer interpretation of the ECG has been called a double-edged sword: when correct, it increases physician accuracy, but when incorrect it incre...
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ECG Cases 29 Misdiagnosis from Lead Misplacement, Artifact and Lead Reversal
In this ECG Cases blog we review 10 cases of possible artifact, lead reversal and lead misplacement. Can you spot the abnormalities and avoid the m...
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ECG Cases 27 Pericarditis – Diagnosis of Exclusion
Jesse McLaren guides us through 9 cases and explains how pericarditis is a diagnosis of exclusion through 3 simple steps: 1. Exclude more serious c...
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Rebellion21: Time to Evolve – Redefining Coronary Ischemia – The OMI/NOMI Paradigm via Tarlan Hedayati, MD
In this 14-minute presentation from Rebellion in EM 2021, Dr. Tarlan Hedayati, MD discusses the shift from the paradigm of STEMI/NSTEMI to OMI/NOMI.
Tactical Medicine News
ECG Cases 25: ‘Late STEMI’ – How acute is the coronary occlusion?
In this ECG Cases blog we look at 10 patients with potentially ischemic symptoms. Which had a coronary occlusion, and how acute were they? Jesse Mc...
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ECG Cases 24 Reciprocal Change and Occlusion MI
Dr. Jesse MacLaren reviews 10 ECG cases highlighting how reciprocal change can be secondary to LBBB/LVH, primary changes, or both, how it can be th...
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Upping Our ECG Game: OMI vs STEMI
Background: Occlusion myocardial infarction (OMI) is defined as acute coronary occlusion or near occlusion with insufficient collateral circulation...
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ECG Cases 21: Hyperacute T-waves and Occlusion MI
In this month's ECG Cases blog, Dr. Jesse MacLaren guides us through 10 cases of patients whose ECGs show tall T-waves and gives us the tools to di...
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ECG Cases 18 – ST DEPRESSED Mnemonic and Occlusion MI
In this ECG Cases blog we look at 10 patients who presented with potentially ischemic symptoms and ST depression. Which had occlusion MI?
The post ...
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OMI-NOMI: Time for a Paradigm Shift
Background: What if we lived in a world where we didn’t call “STEMI alerts”, but instead paged out “OMI alerts”?
In the Reperfusion Era of the late...
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ECG Cases 17 – ST ELEVATIONS mnemonic and Occlusion MI
In this ECG Cases blog we look at 10 patients who presented with ST elevation, and review the differential diagnosis of ST elevation using the ELEV...
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EM Quick Hits 24 Lateral Canthotomy, Cannabis Poisoning, Hyperthermia, Malignant Otitis Externa, BBB in Occlusion MI, Prone CPR
In this month's EM Quick Hits podcast: Anand Swaminathan on lateral canthotomy, Emily Austin on pediatric cannabis poisoning, Reuben Strayer on an ...
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ECG Cases 16: Poor R-wave progression – The LATE mnemonic
In this ECG Cases blog we examine 6 patients who presented with poor R wave progression, and the LATE mnemonic for the differential...
The post ECG...
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ECG Cases 15: Tall R Wave in V1
8 patients presented with ECGs showing a tall R wave in V1. What was the diagnosis? Jesse MacLaren reviews ECG interpretation of a tall R wave in V...
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ECG Cases 14: Q-wave and Occlusion MI
9 patients presented with potentially ischemic symptoms and Q-waves. Which had Occlusion MI? What is the differential diagnosis of Q-waves? How can...
Tactical Medicine News
The DIFOCCULT Trial: Time to Change from STEMI/NSTEMI to OMI/NOMI?
Background: Prior to the discovery of thrombolytics, clinicians could only observe their patients completing their myocardial infarctions and then ...
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ECG Cases 13: LVH and Occlusion MI
LVH produces secondary repolarization abnormalities that can mimic STEMI. Signs of occlusion MI in patients with LVH include: new Q waves/loss of R...
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ECG Cases 12: RBBB and Occlusion MI
In this ECG Cases blog we look at 7 patients with RBBB and potentially ischemic symptoms. Which had RBBB and occlusion MI?...
The post ECG Cases 12...
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ECG Cases 11: LBBB + Occlusion MI
In ECG Cases 11 - LBBB + Occlusion MI Jesse McLaren runs through 5 patients who present with potentially ischemic symptoms and LBBB and explains th...
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ECG Cases 9 – First Diagonal Occlusion
Seven patients with ischemic symptoms, none meeting STEMI criteria but all identified by a specific pattern of first diagonal branch occlusion are ...
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ECG Cases 8 Cardiovascular Emergencies During The COVID-19 Pandemic
In this ECG Cases blog we look at 6 patients who presented with cardiorespiratory symptoms, possibly from COVID and illustrate the dangers of ancho...
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ECG cases 7: ST elevation in aVR, STEMI-equivalent?
10 patients presented with the "STEMI-equivalent" ST elevation in aVR with diffuse ST depression. Which had acute coronary occlusion? Jesse McLaren...
Tactical Medicine News
ECG cases 6: Posterior MI – Still Under-recognized
In this ECG Cases blog we look at 8 patients with potentially ischemic symptoms, none of whom had STEMI on the 12 lead ECG. Which had occlusion MI?...
Tactical Medicine News
JJ 16 Heparin for ACS and STEMI
Does heparin - LMWH or unfractionated heparin - benefit the patient with a pretty good story for angina with a bump in their troponin and some ST d...
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ECG Cases 4: Lateral STEMI or Occlusion MI?
In this ECG Cases blog we look at seven patients with potentially ischemic symptoms and subtle ECG changes in the lateral leads. Which had acute co...
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ECG Cases 3: Can you find the subtle inferior MI?
In this ECG Cases blog we look at 8 patients with potentially ischemic symptoms, to highlight pearls and pitfalls of inferior MI. Can you identify ...
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ECG Cases 2: Early Repolarization or Anterior STEMI?
In this ECG Cases blog we present ECGs from 7 patients who presented with chest pain and mild anterior ST elevation. Can you identify which were ea...
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ECG Cases 1: Missed Ischemia – Never Trust the ECG Computer Interpretation
In EM Cases' first ECG Cases blog we review 7 examples of ECGs of patients presenting to the ED with chest pain, who's ECG were read as normal by t...
Tactical Medicine News
EM Quick Hits 4 Acetaminophen Overdose & Warfarin Interaction, Dental Infections, MTP RABT Score, Statins for STEMI, Cricothyrotomy Tips
In this Quick Hits Podcast: David Juurlink on acetaminophen and warfarin drug interaction, Hans Rosenberg on management of dental infections, Emily...
Tactical Medicine News
More Trials Showing Harm of Opioids in ACS…or do They?
Background: Typical medical treatment of ACS patients include dual antiplatelet therapy (DAPT) and revascularization with primary percutaneous coro...
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Cardiac Arrest, Return of Spontaneous Circulation (ROSC) With No ST-Segment Elevation on ECG. Now What?
Background: The American Heart Association/American College of Cardiology (AHA/ACC) give a Class I recommendation for activation of the cardiac cat...
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REBEL Cast Episode 20: All Cardiology Episode
Welcome to the December 2015 REBELCast, where Swami, Matt, and I are going to tackle a couple of topics in the world of Cardiology and Critical Car...
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REBEL ECG of the Week #8
A 52 year old female with a past medical history of type II diabetes mellitus and tobacco abuse presents with a chief complaint of chest pain.
Acco...
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REBEL ECG of the Week 7
89 year old male with PMH of hypertension, stage 3 chronic kidney disease with chief complaint of shortness of breath. Several days ago patient h...
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REBEL ECG of the Week #6
The case from this week is from one of the PGY-1 residents at University of Texas Health Science Center at San Antonio (UTHSCSA). Several of the d...
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Modified Sgarbossa Criteria: Ready for Primetime?
The recognition of ST-segment elevation myocardial infarction (STEMI) in the presence of left bundle-branch block (LBBB) remains difficult and frus...
Tactical Medicine News
REBEL ECG of the Week #2
58 year old female with chief complaint of chest pain x2hours with PMH of type 2 diabetes mellitus, Hyperlipidemia, and hypertension. She is bro...
Tactical Medicine News
The Importance of Reciprocal Changes in aVL
ECG interpretation is one of the most important skills to master as an emergency physician, and its interpretation can be very complex and frustra...
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