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84 matches for “STEMI” — showing 31–60
Cardiology · Right ventricular infarction V4R ST elevation ★ HY difficulty 3/5

Joseph, a 70-year-old hypertensive man, is brought to Korle Bu Emergency Centre with severe chest pain of 1.5 hours duration. Vitals: BP 88/60 mmHg, HR 105 bpm, RR 22/min, SpO2 95%. He appears pale an…

Cardiology · Benign early repolarisation versus ACS mimics ★ HY difficulty 4/5

Yaw, a 24-year-old healthy man, is seen in the Korle Bu emergency centre after a workplace medical screening flagged an ECG abnormality. He has no symptoms, no cardiac history, and runs recreationally…

Cardiology · Posterior MI — deep ST depression V1-V3 with dominant R wave ★ HY difficulty 3/5

A 70-year-old woman, Yaa, is brought to the Korle Bu Emergency Centre with a 4-hour history of sudden-onset back pain between the shoulder blades, profuse sweating, and vomiting. She is a known hypert…

Cardiology · Transcutaneous pacing / Complete AV block ★ HY difficulty 4/5

A 58-year-old man, Yaw, is referred from a district hospital to the Komfo Anokye ED in Kumasi following an inferior STEMI treated 6 hours ago with streptokinase. On arrival he is alert. Vitals: heart …

Cardiology · NSTEMI risk stratification - GRACE score ★ HY difficulty 3/5

Yaw, a 67-year-old man with hypertension and hyperlipidaemia, presents to the Korle Bu emergency centre with 6 hours of chest pain. ECG shows new T-wave inversion in V1–V4. His GRACE score is calculat…

Cardiology · Anterior STEMI V1–V4 localisation ★ HY difficulty 2/5

Kwame, a 58-year-old farmer, is brought to the Komfo Anokye ED by his family after 3 hours of crushing central chest pain radiating to his left jaw. He has a history of hypertension on amlodipine. On …

Cardiology · Hyperacute T waves — earliest STEMI sign ★ HY difficulty 3/5

Akosua, a 52-year-old market trader with known hypertension, presents to the Komfo Anokye ED with a 30-minute history of severe, crushing central chest pain radiating to her left arm. She is diaphoret…

Cardiology · Inferior STEMI II/III/aVF with reciprocal aVL depression ★ HY difficulty 3/5

Fatima, a 62-year-old woman with type 2 diabetes, presents to a regional hospital ED in the Northern Region with a 2-hour history of epigastric discomfort and vomiting. She denies chest pain. Vitals: …

Cardiology · Modified Sgarbossa criteria for LBBB ★ HY difficulty 4/5

Mohammed, a 66-year-old man with known ischaemic heart disease, arrives at Korle Bu Emergency Centre with 2 hours of retrosternal chest pain. He has a pre-existing left bundle branch block (LBBB) on o…

Cardiology · STEMI thrombolysis window ★ HY difficulty 3/5

Afia, a 55-year-old woman with known hypertension and hyperlipidaemia, presents to a regional hospital A&E with 2 hours of chest pain now partially resolved. Vitals: BP 160/94 mmHg, HR 76 bpm, SpO2 97…

Cardiology · Hyperacute T waves ★ HY difficulty 4/5

Kofi, a 48-year-old man with no prior cardiac history, is brought to the Tamale Teaching Hospital ED with 90 minutes of severe central chest pain and diaphoresis. Vitals: BP 156/94 mmHg, HR 88 bpm, RR…

Cardiology · De Winter T-wave pattern — LAD occlusion equivalent ★ HY difficulty 4/5

A 49-year-old male, Mohammed, is referred from a district hospital to the Korle Bu Emergency Centre with a 2-hour history of crushing central chest pain. He is a known smoker with hypertension and a f…

Cardiology · Cardiogenic shock management ★ HY difficulty 4/5

Yaw, a 61-year-old man, is brought to Korle Bu emergency centre with a 3-hour history of breathlessness and chest pain. He is cold and clammy with a mottled lower limbs. Observations: BP 78/50 mmHg, H…

Cardiology · STEMI thrombolysis ★ HY difficulty 3/5

Kofi, a 58-year-old male farmer, presents to a district hospital in the Bono Region with 2 hours of crushing central chest pain radiating to the left jaw, associated with diaphoresis and vomiting. He …

Cardiology · Aortic dissection — Stanford A vs STEMI differentiation ★ HY difficulty 4/5

A 52-year-old man, Kofi, is brought to the Komfo Anokye ED by his family with a 1-hour history of sudden severe chest pain that radiates to the jaw and left arm. He is hypertensive and diabetic. On ex…

Cardiology · STEMI - PCI vs thrombolysis decision ★ HY difficulty 3/5

Yaa, a 67-year-old woman with known ischaemic heart disease and prior inferior MI 3 years ago, presents to the Komfo Anokye ED with a 2-hour history of anterior chest pain. Her ECG shows 5 mm ST eleva…

Critical Care / Shock · VA-ECMO in refractory cardiogenic shock ★ HY difficulty 4/5

A 62-year-old man, Yaw, is in the Korle Bu Emergency Centre following out-of-hospital cardiac arrest from a presumed STEMI. He was resuscitated after 22 minutes and intubated. Post-ROSC, his BP is 74/…

Critical Care / Shock · Reperfusion in cardiogenic shock without PCI ★ HY difficulty 3/5

A 67-year-old man is referred from a district hospital in the Ashanti Region to Komfo Anokye Teaching Hospital with a 3-day history of worsening chest pain and dyspnoea. He collapsed en route and arri…

ECG - AV Blocks and Bradyarrhythmias · Mobitz I (Wenckebach) complicating inferior STEMI ★ HY difficulty 3/5

Akua, a 55-year-old market trader, is brought to the Komfo Anokye ED with nausea, vomiting, and mild chest discomfort for 6 hours. She is alert, BP 110/70 mmHg, heart rate 44 bpm. A 12-lead ECG is obt…

ECG - Electrolyte Patterns · Hyperkalaemia - peaked T waves, PR prolongation ★ HY difficulty 2/5

Kwame, a 52-year-old man with known chronic kidney disease, presents to the district hospital A&E in Brong-Ahafo with generalised weakness and palpitations. He has missed his last two dialysis session…

ECG - Pulmonary Embolism and Right Heart Strain · Kosuge criteria — simultaneous anteroseptal and inferior T-wave inversions differentiating PE from ACS ★ HY difficulty 4/5

Fatima, a 47-year-old woman, presents to the A&E of a district hospital in the Northern Region with a 2-day history of progressive exertional dyspnoea and mild, non-pleuritic central chest discomfort.…

ECG - STEMI Equivalents · Sgarbossa criteria - concordant ST elevation in LBBB ★ HY difficulty 3/5

Kwame, a 58-year-old man with known hypertension and type 2 diabetes, presents to the Komfo Anokye ED with 2 hours of crushing central chest pain radiating to his left arm. He is diaphoretic and in mo…

ECG - STEMI Equivalents · Wellens syndrome - deep symmetric T-wave inversion V2-V3 (Type B) ★ HY difficulty 3/5

Akua, a 54-year-old woman with known hypertension, presents to the Komfo Anokye ED with a 6-hour history of central chest pain that has now completely resolved. She is pain-free and haemodynamically s…

ECG - STEMI Equivalents · Sgarbossa criteria (original 1996) in LBBB ★ HY difficulty 3/5

Kwame, a 58-year-old man with known hypertension and type 2 diabetes, presents to the Komfo Anokye ED with 2 hours of crushing central chest pain radiating to his left arm. He is diaphoretic and his b…

ECG - STEMI Equivalents · Smith-modified Sgarbossa in paced rhythm - proportional discordance ★ HY difficulty 4/5

Mohammed, a 67-year-old man with ischaemic cardiomyopathy and a permanent VVI pacemaker, presents to the Tamale Teaching Hospital ED with 2 hours of diaphoresis and jaw pain. He is haemodynamically st…

ECG - STEMI Equivalents · Wellens syndrome - deep symmetric T-wave inversion (Type B) ★ HY difficulty 3/5

Yaw, a 66-year-old man with type 2 diabetes and chronic kidney disease, presents to a regional hospital A&E in the Northern Region with a 6-hour history of vague epigastric discomfort and fatigue. He …

ECG - STEMI Equivalents · de Winter T-wave pattern - proximal LAD occlusion equivalent ★ HY difficulty 4/5

Mohammed, a 39-year-old male farmer with no prior cardiac history, presents to the Tamale Teaching Hospital emergency centre with 2 hours of severe epigastric pain and vomiting. He is diaphoretic and …

ECG - STEMI Equivalents · aVR ST elevation - LMCA or proximal LAD occlusion equivalent ★ HY difficulty 4/5

Ama, a 61-year-old woman with known hypertension and diabetes, is brought by ambulance to a regional hospital A&E in Ashanti with a 2-hour history of severe central chest pain radiating to the jaw. Sh…

ECG - STEMI Equivalents · Wellens syndrome - biphasic T in V2-V3 (Type A) ★ HY difficulty 3/5

Kwame, a 54-year-old man with a 3-day history of exertional chest pain that has now resolved, presents to the Komfo Anokye ED. He is pain-free and haemodynamically stable. His troponin is mildly eleva…

ECG - STEMI Equivalents · Smith-modified Sgarbossa - proportional ST/S ratio in LBBB ★ HY difficulty 4/5

Akua, a 64-year-old woman with no prior cardiac history, is brought to a district hospital A&E in Brong-Ahafo by her family after 3 hours of severe epigastric pain and vomiting. The attending medical …