Chest pain, among other symptoms. What do you see?
This patient had many complaints including chest pain.The computer called this ***Acute STEMI***What do you think?STEMI never has a very short QT. This QT interval is 320 ms, with a QTc of around 350, depending on which correction formula you use. (There is Bazett, Fridericia, Hodges, Framingham and Rautaharju -- see here at mdcalc: https://www.mdcalc.com/calc/48/corrected-qt-interval-qtcIf the ST Elevation here were due to STEMI, it would be an LAD Occlusion. You can use myLAD Occlusion/Normal Variant STE formula on this. I did, and the result was the lowest value I have ever obtained (10.4). It is virtually impossible to have an LAD Occlusion with such a low formula value. It is the short QT which drives that value down. When the QT is very short, there are 2 important diagnoses to consider:1. Short QT syndrome. This causes deadly arrhythmias and should be considered in patients with syncope and short QT2. Hypercalcemia.I sent this to Jesse McLaren (@ECGCases) and he immediately responded " Hypercalcemia? "The ioninzed calcium was 6.5 mEq/L (very high).==================================Comment by KEN GRAUER, MD (2/11/2023):==================================Today ’s case is from a patient with “many complaints”, including chest pain — and, an ECG that raised concern about acute anterior OMI. As per Dr. Smith — there are 2 pieces of “good news” regarding this case. These are:On carefu...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Steve Smith Source Type: blogs
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