tag:blogger.com,1999:blog-549949223388475481.post1847754107048709996..comments2024-03-26T22:42:04.176-05:00Comments on Dr. Smith's ECG Blog: An intoxicated, agitated, 29 year old with chest painUnknownnoreply@blogger.comBlogger15125tag:blogger.com,1999:blog-549949223388475481.post-62359297171434194782017-05-20T01:48:20.118-05:002017-05-20T01:48:20.118-05:00"Amazing Post!
I love it. Will come back agai...<br />"Amazing Post!<br />I love it. Will come back again - taking your feeds also.<br />Thanks."!!<br /><br /><a href="http://drmayankjain.com/services/" rel="nofollow">Best doctor for treatment of Heart Failure treatment in Indore</a>Anonymoushttps://www.blogger.com/profile/05249248028987457459noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-28066001965845357072017-05-19T07:03:30.085-05:002017-05-19T07:03:30.085-05:00Tom,
I doubt it. It would only show reciprocal ST...Tom,<br />I doubt it. It would only show reciprocal ST depression. You would still have to determine the CAUSE of the ST depression.<br />I think the principles above are the key.<br />STeveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-84452772523943527132017-05-19T06:58:46.128-05:002017-05-19T06:58:46.128-05:00Al,
good question about the tachycardia.
Partly, b...Al,<br />good question about the tachycardia.<br />Partly, by the time he was able to have an ECG recorded, he must have been more calm and under control.<br />Also, there are some new drugs out there that cause agitation but have paradoxical effects on heart rate.<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-22568399207706846092017-05-19T06:56:01.434-05:002017-05-19T06:56:01.434-05:00Thanks, Dawn!Thanks, Dawn!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-59366933828707620742017-05-19T06:55:22.127-05:002017-05-19T06:55:22.127-05:00It is definitely a very tough case. However, ther...It is definitely a very tough case. However, there are ways to make the diagnosis definite, as described above. By learning these, knowing them, you can convince/educate the interventionalists-cardiologists. At our shop, if the cath lab is activated, they much come in without questioning. That of course only works if you have great skills and confidence in them.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-3905834107816817372017-05-17T18:11:02.154-05:002017-05-17T18:11:02.154-05:00Steve, with the standard 12 lead having real probl...Steve, with the standard 12 lead having real problems detecting anterior MI as in the excellent cases you have described above, is there a place for researching the use of additional lead placements? Would the placement of posterior leads have helped by demonstrating reciprocal change for example?Anonymoushttps://www.blogger.com/profile/13658588389752134458noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-67830913341451167122017-05-17T00:21:17.959-05:002017-05-17T00:21:17.959-05:00- 1. ECG (patient extremely agitated): why not tac...- 1. ECG (patient extremely agitated): why not tachycard ? (Toxycology ?)<br /><br />- "Without Autopsie" could be only a "simple spasm" (or ?) <br /><br />toujours merci (for the excellence)<br /><br />AlAlswissnoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-61103226623664064732017-05-15T08:40:11.094-05:002017-05-15T08:40:11.094-05:00Thank you! This may be complex, but it fills a hug...Thank you! This may be complex, but it fills a huge gap, and has been much-needed for a long time. Anonymoushttps://www.blogger.com/profile/05802836391883716791noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-50190288520379161752017-05-14T20:53:02.569-05:002017-05-14T20:53:02.569-05:00how do you think this case could have played out d...how do you think this case could have played out differently? Think very few providers would get their cardiologists to bite on young, intoxicated male c/o chest pain with that initial ekg. I'm sure most would write it off to early repol. maybe with serial ekgs or echo, but even then it'd be a tough sell. Even more concerning is that we all see quite a few intoxicated and agitated young males/females in the department daily. Similar presentations. Feel as though we are so prone to write it off as demand ischemia, coronary vasospasm, trop leak etc.. in this population. <br /><br />Terrible outcome for the patient. Really tough case. Thoughts???? rexrulestheroosthttps://www.blogger.com/profile/15427884392609600815noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-32250969573416510682017-05-14T09:10:42.727-05:002017-05-14T09:10:42.727-05:00Atherosclerotic plaque rupture.Atherosclerotic plaque rupture.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-3925654246095703122017-05-14T09:10:22.412-05:002017-05-14T09:10:22.412-05:00Thanks, Ken!Thanks, Ken!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-55820033463742166812017-05-14T09:09:38.839-05:002017-05-14T09:09:38.839-05:00The idea is that this relatively normal ECG tells ...The idea is that this relatively normal ECG tells you that the other one is diagnostic of LAD occlusion. This one is due to reperfusion. Sorry for the confusion. Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-44026061670502748802017-05-14T04:39:08.270-05:002017-05-14T04:39:08.270-05:00Superb post with an important message! Otherwise, ...Superb post with an important message! Otherwise, I don't yet see your new 4-variable formula under your Rules + Equations Tab at the top of your blog — so awaiting a way to quickly find your new equation. THANKS for synthesizing this important topic!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-46669525445529520112017-05-13T18:52:00.210-05:002017-05-13T18:52:00.210-05:00Dr. Smith - can you comment on how the last ekg is...Dr. Smith - can you comment on how the last ekg is diagnostic of LAD occlusion? although it definitely looks different than the previous ekg i don't see any STE or hyperacute t waves. is this perhaps the wrong ekg?PMhttps://www.blogger.com/profile/02137437568582174388noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-59222662543878771912017-05-13T10:04:27.576-05:002017-05-13T10:04:27.576-05:00Hello doctor.... Where were this thrombi coming fr...Hello doctor.... Where were this thrombi coming from? MGhttps://www.blogger.com/profile/06233522417024317416noreply@blogger.com