Clinical Tips

ST depression in V1-V3 on a standard 12-lead? Don't stop there. This pattern can mask a posterior STEMI. Action: Requ

F — Fatal: Run STAMP-ED mentally — 6 killers to exclude before any other diagnosis A — Assess: ECG ≤10min, bilateral BP

Mortality increases 1-2% per hour of delay. 8 million ED visits for chest pain each year. The killers hide among the b

6 killers. 10-minute ECG. Every patient. S — ST-Elevation MI / ACS T — Tension Pneumothorax A — Aortic Dissection M —

⬆️ Increases suspicion: • Right arm/shoulder radiation: 4.7 • Both arms radiation: 4.1 • Exertional pain: 2.4 • Diaphor

You press. It hurts. You think musculoskeletal. But up to HALF of heart attack patients have this finding. Likelihood

Reality: Research shows chest pain CAUSES anxiety more often than anxiety causes chest pain. In cardiac patients, psy

Wife says he's "more anxious than usual." He keeps rubbing his left arm. Chest feels "heavy." Looks like anxiety. But

Women, elderly, and diabetics often present WITHOUT classic symptoms. Look for: • Dyspnea may be the only symptom • Un

Aortic dissection = the great mimicker. Only 0.1-0.2% of chest pain, but 1-2% mortality per hour. Classic triad: • Sud

57-70% of young children with septic shock present in COLD shock — the opposite of what most adult-trained clinicians e

COLD Vasoconstricted: • Pale, mottled, cool extremities • Cap refill >2s | Weak pulses • Narrow pulse pressure <20 mmHg