ecg obtuse-marginal-artery 
Dr. Smith's ECG Blog
OCTOBER 30, 2023
Here is the first prehospital ECG (time 0, after one hour of pain): I do not see evidence of OMI, and neither did the Queen of Hearts Here is the 2nd prehospital ECG (time 10 minutes, after 70 minutes of pain): No change On arrival, the first ED ECG was recorded 20 minutes after the last one (90 minutes after pain onset): What do you think?
Dr. Smith's ECG Blog
DECEMBER 27, 2023
The following ECG was obtained. Note that the machine read is "normal sinus rhythm, normal ECG." ECG 1 What do you think? I sent this ECG to Dr. Smith and Dr. Meyers with no clinical context. Smith comment: this troponin alone should be enough data to activate the cath lab, regardless of the ECG. <0.049 ng/mL).
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Dr. Smith's ECG Blog
DECEMBER 6, 2022
Vital signs were normal and first ECG was labeled as normal by the computer and confirmed by the treating emergency physician and cardiology over-read. Repeat troponin declined to 2,500 and repeat ECG ECG was done after another 2 hours, also interpreted as normal. What do you think? Take home 1.
Dr. Smith's ECG Blog
OCTOBER 18, 2023
All initial ECGs were labeled ‘normal’ or ‘otherwise normal’ by the computer interpretation, and below are the ECGs with the final cardiology interpretation. 1-3] But these studies were very short duration and used cardiology interpretation of ECGs or emergent angiography rather than patient outcomes.
Dr. Smith's ECG Blog
NOVEMBER 3, 2023
The baseline ECG is basically normal with no ischemia. Here is what the Queen of Hearts says about the Baseline ECG: Active chest pain triage ECG also read as not OMI: She says "not OMI", but she does not have access to the baseline ECG. In the future, we will be able to have her compare with previous and serial ECGs.
Cook County EM Blog
MAY 15, 2023
There was 100% occlusion of the 1st obtuse marginal artery, a branch of the LCA which was felt to be the culprit for the patient’s presentation. In Critical Cases in Electrocardiography: An Annotated Atlas of Don't-Miss ECGs for Emergency Medicine and Critical Care (pp. J Med Case Reports 16 , 321 (2022).
Dr. Smith's ECG Blog
MAY 6, 2018
Here is his initial ECG: What do you think? Note that there is some ST elevation in V2 and V3, which is normal (ST depression in these leads is very abnormal) So the above first ECG is nearly diagnostic of inferior and posterior MI. When present, the infarct artery is more likely to be the circumflex. This is hard to tell.
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