Chief complaint: “Indigestion” Here’s a video I made breaking down this very important #ECG case from the ER #FOAMed

Follow me if you’re interested in learning more about medical emergencies!

Thanks for sharing! That’s why I as a paramedic always insist on having a 12-lead ECG in patients with abdominal symptoms. Not all of my colleagues agree, there‘s much rolling of eyes, but this way we‘ve found several MIs, that otherwise would‘ve gone unnoticed or delayed.

Indigestion is usu chronic recurring and pts recognise similar past symptoms, often over years. Beware new acute indigestion, especially middle aged men (but not only!). When you ask a pt after MI who thought it was indigestion, they typically never had those symptoms before.

Thanks so much, Jonathan. Agree that paper is a good one. Appreciate all your insights!

Thank you. Very, very important info. I finally bought my husband his Apple Watch with ECG capabilities after many post heart attack visits to the ER with indigestion. He could not distinguish the difference. It’s saved us many ER visits.

"...this is not a subtle ECG" It's not. But the message is an important one.

Atypical presentation, very common in elderly, women and diabetic patients. Keep it up, Sam. I love your account 💘.

Yes indeed, thank you Altaira! ♥️

Thanks Sam: 'tombstones' were mentioned in my EMT training, but further study (including your great Tweets) enabled me to spot this from V2/V4 alone.. the massive elevations in V3 were hidden in landscape! I'm an ECA now (I failed my OSCEs) but hope to get back to EMT soon. :-)

Just chiming in as a layperson to say thank you - always fascinating and even if I don’t understand the specifics, I certainly do get your message.