Tag Archives: Identifying AMI in the presence of LBBB

An unusual case of left bundle branch block – Discussion

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It turns out this patient was experiencing a STEMI.

80 year old male CC: Chest pain

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Here’s a case submitted by a faithful reader who wishes to remain anonymous. It’s a great case and destined to be one of my favorites! EMS is called to evaluate a 80 year old male patient with a chief complaint of chest pain. On arrival the patient is found sitting on his living room couch. […]

58 year old female CC: Chest pain

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Here’s another case study from an international reader who wishes to remain anonymous. Presenting Complaint – Chest Pain History of Present Complaint – 58 year old female, nil cardiac history, mild smoker, social drinker and overweight. Complaining of acute central chest pain @ rest. Awoken by pain. On Arrival – Sat upright on settee (Editor’s […]

62 year old male CC: Chest pain

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62 year old male presents to the emergency department complaining of chest discomfort. Past medical history is significant for dyslipidemia and ulcerative colitis. Also prior history of significant tobacco use. Maternal history of CAD. Maternal and paternal history of stroke. The patient’s only medication is Lipitor but he took an aspinin en route to the […]

Found on the Lifenet Receiving Station

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Is there anything about this ECG (other than the poor data quality) that interests you? The patient was a 90 year old male, fall with injury. Also complaining of pain between the shoulder blades. *** UPDATE *** This ECG caught my eye because it satisfies one of Sgarbossa’s criteria for the identification of AMI in […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Jessica
68 y.o. male with weakness: “Treat the monitor, not the patient?”
the bizzare complexes coupled with the fact that the patient takes a potassium sparing diuretic make me think hyperkalemia
2015-04-29 12:31:37
Aman
The 12 Leads of Christmas: V2
Thank you for your response. By all means, take your time! As for the source of the first figure, I got it from the book "Essential Cardiology: Principles and Practice - 3rd edition" by Clive Rosendorff - Chapter 7, Figure 7.3 (Page 97). It's one of the rare texts where I found a mention of…
2015-04-27 06:52:25
Vince DiGiulio
The 12 Leads of Christmas: V2
Your questions on this topic are some of the best I've encountered—no need to apologize! It makes me very happy to see this post reaching the right people. I'm working non-stop the next two days but I will get back to you soon with my full response. Two things to start: First, where did you…
2015-04-27 05:14:11
AJ
68 y.o. male w/ weakness: conclusion – “Treat the monitor.”
Very informative case! Thank you for sharing..... I will be using it to teach our paramedics and residents (if you allow me to)..... Keep the great working going guys!
2015-04-27 03:05:29
Aman
The 12 Leads of Christmas: V2
Thank you so much! I wonder why this information is not found in ECG texts. I have a query though. The critical information seems to be the fact that leads V1 and V2; V3; and V4-V6, each are physically located on a different transverse plane with respect to the theoretical electrical center. (Also mentioned in…
2015-04-26 18:24:06

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