Chest Pain, " Negative " Stress Tests, POCUS, & ECG Equations -- A Case from Salim Rezaie (R.E.B.E.L. EM)

This case is posted by Salim Rezaie (@srrezaie)Chest Pain, “Negative” Stress Tests, POCUS,& ECG EquationsIt has some peer review by me at the end, so we ' reco-posting!!Chest Pain, " Negative " Stress Tests, POCUS,& ECG Equationsby Salim RezaieI was working a busy shift in the ED, like many of us do, and the next patient I was going to see was a 57 year old male with no real medical problems complaining of chest pain.  I remember thinking as I walked into the room this guy looks ashen and diaphoretic ….he doesn’t look well.  He is a paramedic telling me how he has been having off and on chest pain for the past several months.  He just had a stress test two months ago that was “negative”.  Today he was working on his pool and developed the same chest discomfort as he had been having off and on the past several months, but today, the pain would just not go away.  In his mind, he thought this might be an ulcer and just needed some Pepcid to help. He got put on the monitor and an ECG was run …The patient involved in this case has given permission to share the story, and relevant images with the knowledge that this information will be used for the purposes of education.This was read by the ECG machine as normal sinus rhythm and age undetermined septal infarct.  Looking closer at leads V2 and V3 I can imagine that I am seeing some ST-segment elevation.  Given he was diaphoretic, I was thinking this was an evolving anteri...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs