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Stephen W. Smith
Prof of EM at Hennepin with expertise in ECG, esp Acute MI. Author of book, chapters, papers. Google scholar profile: .
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Stephen W. Smith 11h
At 50 mm/sec, appears to be high degree AVB w wide QRS, but is not. At least 2 P-wave morphologies, & long PR interval. ST depression V2, V3; STE inferior leads --> inferior-posterior OMI. Posterior leads are falsely negative. Q-wave and TWI in III c/w subacute, not acute, MI
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Stephen W. Smith Aug 11
This should terrify everyone.
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Stephen W. Smith Aug 10
Yes, just like the computer says, in German.
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D Villella ❄️ Aug 10
You know what my daughter had to wait 3 WEEKS for? Her COVID test results. You know what got lost? Her COVID test results. Maybe destroying the post office isn't such a great idea after all. doesn't care about popcorn.
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Stephen W. Smith Aug 10
Great new case from . Tachycardia in a Patient With Heart Failure. Challenges in Clinical Electrocardiography. Full text:
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Bob Cesca Aug 9
This new Biden ad is outstanding. And horrifying.
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The Lincoln Project Aug 8
A lot of people are saying they’re regretting voting for trump... I can see why.
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Stephen W. Smith Aug 10
In this case, (in the right clinical setting such as prolonged chest pain) tachycardia is due to low stroke volume as a result of LAD occlusion. This is impending cardiogenic shock.
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Stephen W. Smith Aug 10
With low T/QRS value (none of V1-V4 > 0.36), this is EITHER LV aneurysm OR old MI (LV aneurysm). In other words, if pain duration is > 6 hours, then you cannot tell if old or subacute. With positive troponin (very positive!) this is a subacute MI and emergent cath is indicated.
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Stephen W. Smith Aug 9
Replying to @iceman_ex
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Stephen W. Smith Aug 9
See how the health insurance industry maligned the Canadian Single payor system. The author of that work now admits it was all PR and that the Canadian system is better.
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Stephen W. Smith Aug 9
Replying to @Rhazelovitch @PendellM
Oui. C'est moi qui et un des auteur. Laissons-nous abandonner l'ancien paradigme! et moi, nous avons un autre manuscrit qui et similaire. Nous pouvons identifier les cas avec l'occlusion qui n'ont pas ST+, et de differencier de lesquelles qui n'ont pas l'occlusion.
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Rick Wilson Aug 8
This was such a delight.
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Stephen W. Smith Aug 8
Management of MI can be similar to stroke: Use CT angiogram. Don't depend on STE on ECG for reperfusion? New article from the VERDICT trial may help to change MI paradigm to OMI-NOMI. Coronary CT Angio in Patients w NonSTEMI
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Laurence Tribe Aug 8
Trump’s Postmaster General Louis DeJoy and his wife, Aldona Wos, nominated to become our ambassador to Canada, own between $30 million and $75 million of assets in competitors to the US Postal Service. No problem there, right?
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Stephen W. Smith Aug 8
Posted this a few days ago. Many were skeptical, didn't think ECG findings were due to the OMI. Now have 3 followup ECGs: evolution proves that the first one was ischemic. Here: first and last. Computer and transferring physician say "normal."
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Stephen W. Smith Aug 8
A middle aged female with "heartburn" and a "normal ECG" per the computer
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Stephen W. Smith Aug 7
There’s not always a good explanation. But notice the wide S wave in the new EKG. I think that will account for the difference. I am not convinced that it is OMI. Might be. Outcome?
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Stephen W. Smith Aug 7
I think you have to look at it, but I have seen a lot of these that look just like this and are negative.
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Stephen W. Smith Aug 7
What was it?
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