A great ECG case. One to look out for

This woman was very lucky to meet that Dr. who ordered that ECG and cath. 🙏🙏🙏
Easy miss.

Great take home point on significance of reciprocal ECG changes

Impressive stuff. Tells you how many times we dismiss a lot of patients' complaints just because they are not presenting the way we know in 'textbooks'. The more you practice the more you realize how super common it is for people to present in a completely different manner

A reminder that “classic” ACS symptoms may not occur in a large number of our patients- especially women.

ACS is often not thought of or diagnosed late ➡️poor outcomes.

Great case from Sam Ghali, M.D.
Cc: Penn EM Residency emresidents Fatima Afridi MD ACEP Members Royal College of Emergency Medicine EMTA

Holy crap. Everyone should watch this. We know that there is a gender-imbalance in medical understanding and treatment that disadvantages female patients. This is a great example of a woman who might have died if her care providers didn't take a closer look at her stomach pains.

Clear example of why we must always think and rule out the worst possible scenario, especially when facing patients in the ER.

Great case that highlights why “diseases don’t read textbooks”.

#CardioTwitter #MedTwitter #MedX

Sam Ghali, M.D. Here’s a pic of what a “panic attack” looks like. Thankfully after experiencing a “small” heart attack I found a cardiologist who believed me and performed a heart cath and inserted a stent. Thank you for listening to female patients.

You work in the ER long enough and you'll realise that your best tool is your CLINICAL GESTALT. Massive thumbs up to the physician that ordered a 12-lead ECG for a 'woman with abdominal pain that felt like menstrual cramps'.

This is why 'diseases don't read textbooks' is one of my favourite quotes.

This. This is why listening to women’s complaints and using one’s diagnostics skills vs a very typical scenario of fatigue, heartburn or my favorite you are just anxious. Please listen and use the diagnostic tools at one’s disposal and then think. You will save a life.

🫀My dear female followers ... take a moment.

When abdominal pain - is cardiac.

'Although this patient was triaged to a lower level of care (a noncardiac unit) an astute physician decided to order an EKG.'

Her left circumflex artery that supplies a large portion of the heart…

Une excellente démonstration.

Cette patiente aurait pu facilement avoir un mauvais diagnostic et une mauvaise prise en charge.

Aussi, l’importance de prendre les femmes au sérieux et de considérer l’ensemble des diagnostics.

Thanks Sam Ghali, M.D.
Great case

Repost to save a life

This is a great example of the potential to miss something critical. Video does a nice job explaining this patient from presentation to ER up to diagnosis. Well done to whoever caught this and re-triaged. 🏆

A great demonstration of how easily a patient could slip through the cracks with atypical presentation.

Glad she got the right diagnosis!

Holy hell. She presented with abdominal pain. The end result will blow your mind.

Take women seriously. They typically present atypically. Never brush it off as them being dramatic or having anxiety. This is why heart disease is the number one killer of women. Thanks Sam Ghali, M.D. for bringing awareness!