ECG Cases 57 Art of Occlusion MI Part 5 – Clinical-ECG-POCUS Triptych
In this ECG Cases with Dr. Jesse McLaren we guide you through 6 cases to explore his Clinical-ECG-PoCUS triptych in the identification of Occlusion MI...
ECG Cases 56 – Art of Occlusion MI Part 4: Sequence Photos
In this month's ECG Cases Dr. McLaren explores how sequence photos help identify Occlusion MI. He illustrates through cases how hyperacute T waves and subtle ST elevation with reciprocal ST depression can provide an early snapshot of occlusion MI – and might remain the only sign of occlusion. How resolution of ischemic symptoms along with regional T wave inversion (or reciprocally tall anterior T waves) can indicate spontaneous reperfusion, while subacute and persisting symptoms with Q waves and T wave inversion indicate refractory occlusion. And how spontaneous reperfusion is at risk for reocclusion, with recurrence of ischemic symptoms accompanied by ST/T pseudonormalization and then hyperacute T waves and ST elevation.
ECG Cases 55 The Art of Occlusion MI Part 3 – Impression
In this ECG Cases blog Dr. Jesse McLaren guides us through 6 illustrative cases delving into overall impression in identifying occlusion MI. He discusses how using multiple OMI findings such as acute Q wave, subtle STE, reciprocal STD, hyperacute T waves, and reciprocal TWI to contribute to your overall impression, can double the sensitivity of STEMI criteria for acute coronary occlusion...
EM Quick Hits 64 Whole Blood Transfusions, Calcium Before Diltiazem in Afib, Thoracotomy Pearls, Uterine Casts, OMI Scale & Proportionality
In this month's EM Quick Hits podcast: Zafar Qasim & Andrew Petrosoniak on whole blood transfusion in trauma, Justin Morgenstern on calcium pre-treatment to prevent diltiazem-induced hypotension, Kiran Rikhraj on dynamic LV outflow tract obstruction, Anand Swaminathan on resuscitative thoracotomy, Andrew Tagg on uterine casts, and Jesse McLaren on scale & proportionality in occlusion MI ECG interpretation. **Please support EM Cases to continue to be free open access by making a donation: https://emergencymedicinecases.com/donation/
ECG Cases 54 The Art of Occlusion MI: Scale and Proportionality
On this month's ECG Cases, Dr. Jesse McLaren explains how STEMI criteria can be false positive with large scale QRS and proportional ST elevation, or false negative with low/normal scale QRS and disproportionate ST elevation and hyperacute T waves, and that rules for subtle occlusion using proportionality can help differentiate LBBB with or without Occlusion MI, or LV aneurysm vs anterior STEMI with Q waves... Please consider a donation to EM Cases to ensure continued Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/
ECG Cases 53 – The Art of Occlusion MI, part 1: Mirror Image
In this month's ECG Cases Jesse McLaren takes us through 6 cases highlighting important mirror concepts in ECG interpretation including: which leads are reciprocal to each other, how to identify which is the main ST/T change and which is the mirror, reciprocal changes highlighting subtle inferior, lateral and posterior OMI, ST elevation in aVR as a mirror to widespread ST depression and more...
ECG Cases 52 – ECGs falsely labeled “normal”
In this ECG Cases Dr. Jesse McLaren outlines why not to trust the ECG interpretation, even if normal, because it can miss critical findings. He explores how to independently and systematically interpret every ECG so that when the computer ECG interpretation says "normal" you don't miss key findings... Please consider donating to EM Cases to ensure it stays Free Open Access https://emergencymedicinecases.com/donation/
EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments
In this month's EM Quick Hits podcast: Megan Landes on the importance of diagnosing HIV in the ED, Jesse McLaren on the failed paradigm of STEMI criteria and ECG tips to identify acute coronary occlusion, Anand Swaminathan on evidence for non-invasive airway management in the poisoned patient, Brit Long and Hans Rosenberg on the identification, workup and management of spontaneous bacterial peritonitis, Matt Poyner on the most lucrative side-gig, DIY investing. To support EM Cases, please consider a donation here: https://emergencymedicinecases.com/donation/
ECG Cases 50 – STEMI: A Failed Paradigm, Enter Occlusion MI
Dr. Jesse McLaren illustrates the paradigm shift from STEMI to Occlusion MI (OMI) through 9 cases, and drives home the points that if there is STEMI criteria, consider false positives (eg. secondary and proportional to LVH or BER); if there is no STEMI criteria, consider false negatives and look for other signs of occlusion (eg. acute Q waves or loss of R waves, hyperacute T waves, or reciprocal STD/TWI) and if the ECG is nondiagnostic, consider other OMI signs including clinical (refractory ischemia, hemodynamic/electrical instability) and POCUS (new regional wall motion abnormalities).
ECG Cases 49 – ECG and POCUS for Dyspnea and Chest Pain
In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. They explain complementary diagnostic insights into pericardial effusion and cardiac tamponade, occlusion MI and RV strain...