Tag Archives: benign early repolarization

The early repolarization experiment

Entry Img

Any paramedic who has studied the STEMI mimics has heard of the classic benign early repolarization pattern of a "fish-hooked" J-point with upwardly concave (smiley-faced) ST-segment, often best appreciated in lead V4. But, as the excellent work of Stephen Smith, M.D. demonstrates, not all cases of early repolarization present this way, and it can often […]

50 year old male CC: Chest Pressure – Discussion

Entry Img

This is the discussion for 50 year old male CC: Chest Pressure. We could not have been happier at the number of insightful comments we received on this case! Many of you caught on to our purpose for this case as we could not have picked a better borderline example! When we last left our […]

53 year old male with a suspicious ECG – Conclusion

Entry Img

This one was really challenging because we all know that reciprocal changes are strongly supportive of acute STEMI.

Is this a mimic or the real thing? – Discussion

Entry Img

This is the follow-up discussion to: Tweet about ECG leads to mystery – is this a mimic or the real thing? Let’s take another look at the 12-lead ECG. This is a very suspicious ECG and must be considered acute inferior STEMI until proven otherwise. This was my initial gut feeling about this ECG and […]

Early Bird Gets the Worm – Conclusion

Entry Img

The conclusion to the November 2010 EMS 12-Lead column Early Bird Gets the Worm is now posted at EMS1.com. Early Bird Gets the Worm: Patient Follow-Up You can become a fan of EMS1.com on Facebook by clicking HERE.

63 year old male CC: Syncope – Conclusion

Entry Img

Here is the conlcusion to 63 year old male CC: Syncope. First, let’s take another look at the 12-lead ECG. This 12-lead ECG shows poor data quality. This is a problem because the ECG is abnormal and suspicious for acute anterior STEMI. We need to consider whether or not this could be benign early repolarization […]

47 year old female CC: Chest pain – Discussion

Entry Img

Thanks for all the comments! I’m not allowed to blog while I’m on duty (the policy has nothing to do with me personally) so if it seems like I’m not responding, I’m probably just at work. The paramedic who submitted this case has requested the follow-up information from his supervisor, but unfortunately she’s out-of-town for […]

23 year old male CC: Chest Pain

Entry Img

Here’s a fascinating case submitted by Geoff Dayne. EMS is called to a VA clinic for a 23 year old male who came in to get checked into the system. Somewhere in the exchange, he mentioned that he had been experiencing chest pain off & on for just over a month. Onset: Today’s pain came […]

41 year old male CC: Chest pain – early repolarization?

Entry Img

41 year old male complaining of chest discomfort. Past medical history: Asthma Medications: Inhaler (unknown type) EMS finds the patient sitting in a chair. The patient appears acutely ill. His skin is cool, pale, and diaphoretic. Breath sounds clear bilaterally. Onset: At rest Provoke: Nothing makes the pain better or worse Quality: “Heavy” and “unrelenting” […]

The problem of ST segment elevation

This post has been updated and moved here: http://www.ecgmedicaltraining.com/the-problem-of-st-segment-elevation/.