Sam Ghali, M.D.

Here’s a message that was sent to me by an ER resident physician in training who saved a patient’s life half way across the country from me. When people ask “why teach on social media?” This is why.

@jpcostabel Complete AV Block with Left Anterior Fascicular Escape

Qué le está pasando?

@MSharifpourMD Pure flow destruction!

When you need to rapidly transfuse/resuscitate a patient, make sure to take out the skinny J-loop and replace it with a larger one or remove entirely or it will make your large bore IV useless (picture posted w/ permission)

The interesting thing is the incredibly similar ST-T wave morphology in the inferior leads. So do we think this represents reciprocal change (and just happens to have this same appearance) or are they actually de Winter-like T waves also representing transmural ischemia (WrapAround LAD) ? 😄

@RobertHermanMD @PendellM @ecgandrhythmRoe @ecgrhythms @TheECGMedic @DrparrayMD @DrRazi4 @EM_RESUS @AndrewACNP1 @tbouthillet Culprit is Proximal LAD. de Winter variant. But it embolized to mid LAD resulting in high lateral reperfusion. (de Winter signifies some very minimal flow such that there is fusion of STD of SEI and hyperacute T waves

🔴LIVE #ECG case: prehospital cathlab activation from a hospital system practicing AI-assisted OMI/NOMI paradigm instead of STEMI/NSTEMI. What's the most likely culprit?

@RobertHermanMD @smithECGBlog @PendellM @ecgandrhythmRoe @ecgrhythms @TheECGMedic @DrparrayMD @DrRazi4 @AndrewACNP1 @tbouthillet LAD possibly even Left Main vulnerable plaque with some degree of reperfusion/flow when this ECG was shot

@DrparrayMD @amalmattu @DrRazi4 @PendellM @RobertHermanMD @ShariqShamimMD @ecgandrhythmRoe @EcgsOnly @MirSuhayel @The_Nanashi_O Acute Proximal RCA Occlusion with RV Infarction

84-year-old female OOHCA . ROSC but unfortunately suffered cardiac arrest shortly afterwards and died despite maximal resuscitative efforts. The post-ROSC ECGs below tell an important story. Thoughts ?#cardiotwitter #ecg #@smithECGBlog

@TrackYourHeart Looks Underdampened. Do the Square Waveform. Confirm transducer positioning and consider noninvasive site.

A 28-year-old man presents with severe hypertension and dyspnea. Automated cuff BP reads ~200 mmHg systolic, but arterial line shows 300+ mmHg, correlating with his symptoms. What is the most likely diagnosis or explanation?

@4jtweet @HeartOTXHeartMD @YouTube 😂

@HeartOTXHeartMD @EM_RESUS @YouTube He would put Little Debbie on unemployment.

I heard the voice and the cadence, and immediately thought to myself, “What if @EM_RESUS , did a baking show?”!😊🤣 Easiest Peanut Butter Chocolate Chip Cookies Ever youtube.com/shorts/6pWLQY8… via @YouTube

@VRBoombatzMDPhD @HeartOTXHeartMD @YouTube 😂

@EM_RESUS @HeartOTXHeartMD @YouTube Coming soon to a Dr. Sam video near you: sound effects. And chocolate chips.

@PulmCrit Sure, as an isolated absolute value—but would you agree Josh that within a steady state of hemoglobin and O2, ScvO2 trends can be helpful?

ScvO2 is so hot right now. About a decade ago we had a patient in shock with terrible echo windows. ScvO2 was high, so the team thought sepsis. Antibiotics failed. Autopsy showed MI. We had an M&M conference. Everyone was confused about why the ScvO2 misled us. … #1/2

@naleen14 @smithECGBlog @RobertHermanMD @amalmattu Easy RBBB LAD Occlusion. Hope he got prompt reperfusion!

42 yr old male with no past medical issues presented to ED with chest pain on exertion. Had 3 witnessed VF arrests and shocked. This is the first ECG, which is very interesting. What are your thoughts? Of course I consulted Queen of Hearts @smithECGBlog

@smithECGBlog @PendellM @PMcardioApp Nice case. Was it a WrapAround LAD? (the distal portion of the vessel is cutoff on the angiogram shot!)

Will this patient get care of the past or care of the future? (NSTEMI is a worthless diagnosis) drsmithsecgblog.com/will-this-pati… @PendellM @PMcardioApp

@DrparrayMD @smithECGBlog @ShariqShamimMD @DrRazi4 @PendellM @The_Nanashi_O @amalmattu @RobertHermanMD @ecgandrhythmRoe A definite victim of STEMI Criteria. Perhaps a victim of sex and young age bias. Improvement in pain with morphine is means nothing and only muddies the water. Hopefully the occluded coronary artery was opened up promptly after she arrested.

34F with chest pain .Given aspirin + morphine, troponin pending. Suddenly went into VF cardiac arrest → ROSC after CPR/defib. ECG attached. Thoughts? What was missed, and what could have been done better? #ECG #MedTwitter #FOAMed @smithECGBlog @ShariqShamimMD @EM_RESUS

Check out this recent educational video:

I have nothing to advertise except what I have to teach—follow me if you’re interested in learning about medical emergencies

Yes

@SGR5N Yes

@EM_RESUS Am I the only one who didn’t get the joke here?

Hi, ER Doc here. I don’t know who needs to hear this but do NOT even think about it.

Don’t ask questions. Just pass it on.

@ross_prager Hopefully an ECG for this patient does not exist 😄

What does the ECG show for this patient? 🫀⚡️