Chest pain

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See also: Cardiovascular symptoms

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ECG Library (466)

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In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST depression Hyperacute T waves Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
A 40 year old man with chest pain since last night

This ECG is from a man in his 40s who presented with chest pain since the previous evening, associated with vomiting and diaphoresis. He had recently stopped smoking.

This ECG shows subtle disproportionately tall T waves in V2-V3 and ST depression in V3-6 with slight ST elevation in V1. The cause was a 100% proximal LAD thrombotic occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Hyperacute T waves Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
A patient with chest pain that is resolving. Computer interprets ED ECG as completely Normal.

This ECG is from a man in his 60s who presented with resolving chest pain.

This ECG shows hyperacute T waves in V2-4. The cause was an 80% obstruction of the LAD with a large thrombus. An earlier ECG showed ST segment elevation.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Excessive discordant ST elevation Pacemaker spikes Ventricular pacemaker 12-Lead Dr Smith's ECG Blog CC BY-NC
Acute chest pain in a patient with cardiomyopathy and a paced rhythm.

This ECG is from a woman in her 70s who was awoken with sharp chest pain on a background of cardiomyopathy, ICD and LVH.

This ECG shows paced rhythm with modified-Sgarbossa positive discordant ST elevation in I, aVL and V2. Angiogram did not find a culprit and echo did not find a wall motion abnormality. The cause remains a mystery.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Hyperacute T waves Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
A 50-something male with acute chest pain

This ECG is from a man in his 50s who presented with chest pain and diaphoresis.

This ECG shows anterior ST elevation and hyperacute T waves due to 100% LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Hyperacute T waves 12-Lead Dr Smith's ECG Blog CC BY-NC
What happens when you don’t recognize an OMI?

This ECG is from a man in his 60s who presented with chest pain.

This ECG shows hyperacute T waves and anterior ST elevation that evolved to cardiogenic shock due to a left main occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Coved ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
A Middle-Aged male with Chest Pain and an Unusual ECG

This ECG is from a middle aged man who presented with chest pain.

This ECG shows coved ST elevation in V1-3. It did not evolve on serial ECGs. It may have been an unusual Brugada pattern.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Lateral ST depression Sinus arrhythmia Acute Inferior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
A 40 yo with Chest pain. Only ECG abnormality is minimal ST depression in I and aVL (computer interpretation: normal)

This ECG is from a man in his 40s who presented with 1 hour of chest pain.

This ECG shows sinus arrhythmia with slight ST depression in I and aVL. Serial ECGs showed evolution to an inferior STEMI, due to a 100% RCA occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Hyperacute T waves Acute Anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
How long would you like to wait for your Occlusion MI to show a STEMI? Sometimes serial ECGs minimizes the delay.

This ECG is from an elderly woman who presented with acute chest pain and shortness of breath.

This ECG shows sinus rhythm with minimal ST elevation in V1-3 and hyperacute T waves in V2. Serial ECGs evolved to a clear STEMI. The cause was a 100% mid-LAD occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Hyperacute T waves Septal ST elevation Mid-anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
The delay between OMI and STEMI claims yet another patient’s anterior wall

This ECG is from an elderly woman who presented with chest pain and shortness of breath.

This ECG shows ST elevation in V2 with hyperacute T waves in V2-3. Even though this does not meet STEMI criteria, it is highly suspicious. Serial troponins did rise, pain was ongoing and the ECG evolved to meet STEMI criteria. A 100% mid-LAD occlusion was found to be the cause. Echo showed widespread wall motion abnormalities and reduced ejection fraction.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Inverted T waves Normal Sinus Rhythm Premature atrial complex Acute right heart strain Pulmonary embolism 12-Lead Dr Smith's ECG Blog CC BY-NC
An elderly woman transferred to you for chest pain, shortness of breath, and positive troponin – does she need the cath lab now?

This ECG is from an elderly woman who presented with sudden onset shortness of breath after months of inactivity due to a back injury.

This ECG shows sinus tachycardia with large inverted T waves, consistent with right heart strain. The cause was a very large PE.

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