Category: Dr. Smith’s ECG Blog

15 yo AAM with ST Elevation and T-wave Inversion. Hypertrophic Cardiomyopathy or Normal (“Variant”)?

Is this normal or hypertrophic cardiomyopathy (HOCM)? The mother of a 15 yo African American male brought her son to the clinic for a sports physical.  There was a family history of sudden death.  The clinic recorded this ECG and was alarmed: Should the physician be alarmed by this? Answer: No. This is almost certainly

Profound ST Elevation in V1-V3. What do you think?

This ECG comes from Pierre Taboulet ( an ECG whiz who codes a lot of ECGs for Cardiologs’ Artificial Intelligence Deep Neural Network algorithm ( I do research on Cardiologs’ algorithm:Smith SW et al. A Deep Neural Network learning algorithm outperforms a conventional algorithm for emergency department electrocardiogram interpretation. Cardiologs founder, Yann Flereau, was named by

Dynamic, Reversible, Ischemic T-wave inversion mimics Wellens’. All trops negative.

A middle-aged man presented with 7-8/10 non-radiating chest tightness to the left chest wall, associated with nausea but no diaphoresis, that began while walking approximately 40 minutes prior to arrival at the ED. The pain resolved as he arrived to the emergency department. He had 2 episodes over the past 2 days of similar chest tightness.

Found comatose with prehospital ECG showing “bigeminal PVCs” and “Tachycardia at a rate of 156”

This patient with a history diabetes was found with a GCS of 4. Prehospital EKG and strips (not shown) had “heart rate 156” (according to the computer interpretation) and “Bigeminal PVCs” The prehospital 12-lead looked just like the first ED ECG: What do you think? Answer: The “bigeminal PVCs” is really a QRS followed by