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Triage 17:41

HyperTMissed MI12-lead ECG FOAM Pendell Meyers, Steve Smith A man in his 50s with schizophrenia, hypoglycemia, and vague chest pain and shortness of breath for a few days Dr Smith's ECG Blog

Serial

ArrestIsolated Posterior MIMissed MI12-lead ECG FOAM Pendell Meyers, Steve Smith Cardiologist declines taking patient to the cath lab. Patient dies. Dr Smith's ECG Blog
Isolated Posterior MIMissed MI12-lead ECG FOAM Pendell Meyers, Steve Smith Cardiologist declines taking patient to the cath lab. Patient dies. Dr Smith's ECG Blog

13min later

Chest LeadsMissed MIVentricular Pacing ECG FOAM Pendell Meyers, Steve Smith, Brooks Walsh Anterior MI in paced rhythm, dismissed by cardiologist, patient died. Dr Smith's ECG Blog
ArrestMissed MIPaced Inferopost MIVentricular Pacing ECG FOAM Pendell Meyers, Steve Smith See what happens when one fails to diagnose STEMI in LBBB and Paced Rhythm Dr Smith's ECG Blog
Missed MIPaced Inferopost MIVentricular Pacing ECG FOAM Pendell Meyers, Steve Smith See what happens when one fails to diagnose STEMI in LBBB and Paced Rhythm Dr Smith's ECG Blog

After atropine

BradyLBBBMissed MIWenckebachLBBB Inferopost MI ECG FOAM Pendell Meyers, Steve Smith See what happens when one fails to diagnose STEMI in LBBB and Paced Rhythm Dr Smith's ECG Blog

Next morning

LAD occlusionMissed MISTE ECG FOAM Steve Smith Resuscitated from ventricular fibrillation: what is the ECG Diagnosis? Dr Smith's ECG Blog

Initial

LAFB + RBBBMissed MIProx LAD MI - Bifasc ECG FOAM Steve Smith Resuscitated from ventricular fibrillation: what is the ECG Diagnosis? Dr Smith's ECG Blog

After treatment

Missed MIRCA OcclusionSubtle Lateral MI ECG FOAM Steve Smith Pericarditis? Or STEMI? The difference can be fatal. Dr Smith's ECG Blog

4.5h later

Anterior STELAD occlusionMissed MIPathological Q Wave ECG FOAM Steve Smith Anatomy of a Missed LAD Occlusion (classified as a NonSTEMI) Dr Smith's ECG Blog

Next day

Missed MIRight Ventricular MI - V1Subtle Inferior Reciprocal Change MI ECG FOAM Steve Smith The ECG told the whole story, but no one listened: ECG interpretation skills are critical to patient outcomes. Dr Smith's ECG Blog
ArrestMissed MISTD ECG FOAM Steve Smith Missed myocardial infarction with subsequent cardiac arrest Dr Smith's ECG Blog

117min later

Classic Inferoposterior MIMissed MI ECG FOAM Steve Smith Chest Pain in a Male in his 20's; Inferior ST elevation: Inferior lead "early repol" diagnosed. Is it? Dr Smith's ECG Blog

Post transfer, 95min later

Classic Inferoposterior MIMissed MI ECG FOAM Steve Smith Chest Pain in a Male in his 20's; Inferior ST elevation: Inferior lead "early repol" diagnosed. Is it? Dr Smith's ECG Blog

Prehospital

Missed MISubtle Inferoposterior MI ECG FOAM Steve Smith Chest Pain in a Male in his 20's; Inferior ST elevation: Inferior lead "early repol" diagnosed. Is it? Dr Smith's ECG Blog

Serial

Anterior MILAD occlusionMissed MI ECG FOAM Steve Smith A Tough ECG, But Learn From It! Dr Smith's ECG Blog

Initial

Anterior STEHyperacute T MI - TallLAD occlusionMissed MI ECG FOAM Steve Smith A Tough ECG, But Learn From It! Dr Smith's ECG Blog

After CABG day 5

LAD occlusionMissed MIPathological Q WaveRe-occlusion ECG FOAM Steve Smith Prehospital ST Elevation and pain resolve with NTG. ECG and Echo normal in ED. Dr Smith's ECG Blog
HyperTInf STDLAD occlusionMissed MI ECG FOAM Steve Smith 35 yo woman with LAD occlusion manifesting with only hyperacute Ts and inferior ST depression, also missed by computer Dr Smith's ECG Blog
ArrestLCx OcclusionMissed MIRecip STD ECG FOAM Steve Smith ST depression limited to Inferior leads is reciprocal to high lateral wall and represents STEMI Dr Smith's ECG Blog

Initial, pain free

LBBBMissed MI ECG FOAM Steve Smith If there is high suspicion for ischemia, do serial EKGs and pay attention to them! Dr Smith's ECG Blog

40min later, pain recurrent

Missed MISubtle Anterior MI ECG FOAM Steve Smith If there is high suspicion for ischemia, do serial EKGs and pay attention to them! Dr Smith's ECG Blog

Initial, pain free

Missed MINondiagnostic ECG ECG FOAM Steve Smith If there is high suspicion for ischemia, do serial EKGs and pay attention to them! Dr Smith's ECG Blog