Two ECGs texted to me in the same hour. What would you recommend?

Written by Pendell MeyersBoth of these cases were sent to me with no information other than adults with acute chest pain. What would be your response?Case 1:Case 2:What if I told you that Case 1 has an abnormal initial troponin, and Case 2 has a normal initial troponin? Case 1An elderly male presented with chest pain. His vitals were within normal limits except some mild hypertension. Here was his triage ECG:What do you think?I texted back: " I just see LVH with no signs of OMI " .I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict:You can subscribe for news and early access (via participating in our studies) to the Queen of Hearts here: https://bit.ly/omi-queen-formThen I learned that a Code STEMI was activated for concern of anterior " STEMI " in V1-V2. The cath lab activation was appropriately cancelled by cardiology.High sensitivity troponin I was 23 ng/L. Two more serial trops were each 23 ng/L.He did not have OMI.We think that Queen of Hearts may have the ability to reduce such false positive cath lab activations. We will study this soon.Case 2A man in his 60s presented with acute chest pain, about 1 hour prior to evaluation:What do you think?I texted back: " easy LAD OMI. "There are diagnostic hyperacute T waves in V2-V5, I, aVL, and II. There is 0.5 mm STE in V1, and 1.0 mm STE in V2. There is also 0.5-1.0 mm STE in aVL. In V3-V6, and II, III, aVF, the J point is depressed. Thus, leads V3-V5 and II are perfect de Winter m...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs