A man in his 60s with acute chest pain and high voltage

Sent by Anonymous, written by Pendell MeyersA man in his 60s with history of CAD and 2 prior stents presented to the ED complaining of acute heavy substernal chest pain that began while eating breakfast about an hour ago, and had been persistent since then, despite EMS administering aspirin and nitroglycerin. There was associated diaphoresis, but no dyspnea, nausea, or vomiting. He reported having covid 2 weeks ago, but had seemingly fully recovered.Triage 1104:What do you think?The triage ECG was sent to me with no history (I did not have access to baseline ECGs), and I said that I thought this was just LVH causing the anterior STE and T waves. I told the sender that I did not see OMI. I sent this ECG (with no history, no baseline ECG) to Dr. Smith twice, months apart, and he also said LVH without clear OMI.PM Cardio Queen of Hearts interpretation of the triage ECG: " Not OMI high confidence "However, there were several prior / baseline ECGs on file:What do you think now? (both of these ECGs are " Not OMI High Confidence " by PM Cardio Queen of Hearts AI).Compared to baseline, there is more STE in anterior leads, and significantly increased area under the curve of the T wave in V3 and V4. By seeing the comparison, the diagnosis is LAD OMI until proven otherwise.The triage ECG was interpreted correctly as " No STEMI. " Due to the state of the ED at the time, the patient was placed in a waiting area. The first high sensitivity troponin I returned elevated at 25 ng/L (uppe...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs