A man in his 50s with chest pain

 Sent by anonymous, written by Pendell MeyersA man in his 50s with no prior known medical history presented to the Emergency Department with severe intermittent chest pain. He had episodes of chest pain off and on all night, until about 1 hour prior to arrival when the pain became constant, crushing, 10/10 chest pain that radiated to both arms. He denied any lightheadedness, shortness of breath, vomiting, or abdominal pain. Vitals were within normal limits.Here is his triage ECG at 0343:What do you think?Meyers interpretation: Diagnostic of LAD OMI, with hyperacute T waves in a large LAD distribution including precordial leads, high lateral leads, and inferior leads. Barely any STE, and thus not meeting STEMI criteria. Yet completely diagnostic of acute LAD occlusion.Here is the response from PM Cardio ' s Queen of Hearts AI model:Trained with many cases of hyperacute T waves, the AI confidently diagnoses them in this case.Read our recent editorial: Hyperacute T-waves Can Be a Useful Sign of Occlusion Myocardial Infarction if Appropriately Defined. Annals of Emergency MedicineCardiology was called to evaluate the patient immediately for emergent cath, but they stated that the ECG did not meet STEMI criteria and elected to wait for further information before proceeding with cath.He was given 6mg IV morphine for ongoing pain. His initial troponin T returned at 0.03 ng/L (abnormal for this assay is anything greater than 0.01, which is also the limit of detection, ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs