Lorin Braschler, MD

34yo male Chest pain and shortness of breath URTI since 3 days cTnI 259ng/l Dx? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX

21yo male Intermittent palpitations and burning chest sensation No positive family history for SCD Dx? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX

31yo male Intermittent palpitations Infrequent cocaine use Dx? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX

@ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_RESUS Answer: inferoposterior OMI 🚨 The patient was referred for emergency ICA which reveiled thrombotic occlusion of pRCA, severe stenosis of distal LM, pLAD and mid LCX. pRCA and pLAD was successfully treated with DES. The other lesions were scheduled for staged PCI.

42yo male Slight intermittent chest pain since 2 days, nausea and vomiting cTnI >15'000ng/l Dx? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX

Physically active 22yo male with this rhythm at rest? What are your thoughts? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX

@ecgandrhythmRoe LAD OMI with HATW and frequent SVES

A 50-year-old man with familial hypercholesterolemia who develops chest pain during a bicycle ergometer test. What do you think?

81yo male Dizziness after spinal anesthesia No prior history of rhythm disorders or heart disease Dx? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX

@ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_RESUS Answer: severe MVD with LM-bifurcation stenosis 🚨 The patient was taken to the cath lab reveiling severe MVD with LM-bifurcation stenosis. Probable culprit was the severely diseased LAD which was treated with 3 DES, because of unsuitability for CABG due hemodynamic instability

67yo male OHCA with ROSC Dx? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX

@MergencyFe @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_RESUS ~30-40min

@cardiodevotee @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_RESUS How many minutes after rosc? If >10-15 consider Left main occlusion

@Ecgloverr @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_RESUS ~ 30-40min

@cardiodevotee @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_RESUS How long the ecg taken after ROSC ?

@cardiodevotee @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @Arron_Pearce_ @ECGwithReid @EM_RESUS Important caveat: MINOCA due to coronary vasospasm cannot be distinguished based on ECG findings alone. While the absence of RWMA makes such an extensive MI pattern on ECG appear less likely, these patients still require coronary angiography to exclude plaque rupture.

@ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_RESUS Answer: MINOCA due to coronary vasospasm 🚨 The patient was sent for immediate ICA which revealed non-obstructive coronary arteries. However, after contrast injection the coronaries showed increased spasmic properties normalizing after administration of nitrates.

47yo male Recurrent CP cTnI 10ng/l LVEF 62% no RWMA cvRF DM Type II, HTN, 20py Dx? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX

@ecgandrhythmRoe @doc_ecmo @frollein_doktor @EPWaveDoc @RobertHermanMD Very nice catch!

@doc_ecmo @cardiodevotee @frollein_doktor @EPWaveDoc @RobertHermanMD

Manchmal zeigen Extrasystolen einen Herzinfarkt besser an als die nativen Schläge, lol! @MergencyFe @andreaskardio @Herzspitze @LiffersGert @fbalex19071 @SwissHeartDoc @moflsis @diggewitz @MachereyMeyer @WeyandSebastian @IrmaMDv

@ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_RESUS Answer: inferoposterolateral OMI with subsequent cardiogenic shock🚨 The patient was immediately taken to the cath lab which showed a complete occlusion of mid RCA. The culprit lesios was treated with a DES and subsequent no-flow phenomenon occurred in the distal PLB.

Scary but very illustrative ECG! 74yo female CP radiating to left arm Metabolic syndrome BP 96/58mmHg, HR 52 bpm Dx? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX

50yo male Dizziness and palpitations Dx? @ecgandrhythmRoe @EcgOxford @DrRazi4 @PendellM @RobertHermanMD @Arron_Pearce_ @ECGwithReid @EM_Resus @PMcardioBot #ECG #CardioTwitter #MedTwitter #MedX