Emre Aslanger @AslangerE Twitter profile

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Emre Aslanger

4 days

Exciting News! Proudly presenting my latest title: 'Cardiopulmonary Exercise Testing.' Unravel the complexities of exercise pathophysiology and CPET. Now available on Amazon, Apple Books, and Google Play. #NewRelease #CPET

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Emre Aslanger

@AslangerE

2 years

Two ECGs from the same patient. The common abnormality was diagnosed unfortunately only after the rhythm turned into AF. What is it and why ?

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Emre Aslanger

@AslangerE

2 years

57 yo f presents with 1h of pain on both arms.

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Emre Aslanger

@AslangerE

2 years

70 something man is brought to ED with worsening of general status. What do you think ?

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Emre Aslanger

@AslangerE

2 years

46 yo male presents with crushing chest pain. What do you think ?

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Emre Aslanger

@AslangerE

1 year

75 yo female presents with fatigue. What do you think of this ECG ?

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Emre Aslanger

@AslangerE

2 years

Cath lab activated b/c of this ECG from a 60 yo f who presented with chest pain. Which artery do you think is responsible ?

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Emre Aslanger

@AslangerE

3 years

53-year-old male presents with crushing central chest pain. Is this ECG diagnostic for anything ?

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Emre Aslanger

@AslangerE

3 years

50 yo male presents with palpitation. Here is his first ECGs before and after adenosine. What happened ?

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Emre Aslanger

@AslangerE

2 years

50 something female presents with episodic pain. What do you think ?

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Emre Aslanger

@AslangerE

2 years

What's happening here again ?

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Emre Aslanger

@AslangerE

3 years

50 something male with typical chest pain. Is this STEMI ?

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Emre Aslanger

@AslangerE

3 years

JUST FOR FUN !! Try my hand-made visual acuity test for OMI ! If below guideline limits (red line) consult @smithECGblog , if below 'clear-as-day' limit (green line) see an ophthalmologist 😊

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Emre Aslanger

@AslangerE

5 months

Hemodynamics is fascinating. PCWP may be surprisingly misclassifying PH patients, read our latest article at:

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Emre Aslanger

@AslangerE

2 years

This one is from my shift yesterday, 50 something male, presents with chest pain. STE present only in lead III (Aslanger pattern). Acutely occluded RCA and a chronic 80% stenosis in LAD.

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Emre Aslanger

@AslangerE

2 years

60 yo male presents with left sided stabbing pain. What is your interpretation ?

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Emre Aslanger

@AslangerE

2 years

75 yo male presents to outpatient clinic with intermittent chest burning for 2 weeks. He is pain free now, but his ECG is shown below. What would you do ?

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Emre Aslanger

@AslangerE

3 years

A comprehensive, step-by-step approach to OMI ECG by @AslangerE , @PendellM and @smithECGBlog . Open access at Turk Kardiyol Dern Ars (), check it out and please share your opinions: Turkish: English:

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Emre Aslanger

@AslangerE

1 year

We are happy to announce that our OMI Toolbox App is now online and free to download. @smithECGBlog @PendellM iOS: Android:

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Emre Aslanger

@AslangerE

2 years

An easy one, but unfortunately nearly half of the interns I asked picked an alternative diagnosis. 50-something male presents with chest pain. What do you think ?

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Emre Aslanger

@AslangerE

2 years

30 something male presents with syncope at home, now has some dyspnea.

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Emre Aslanger

@AslangerE

2 years

Consulted from psychiatric ward due to 2-3 min tingling pain over left breast, in a now pain-free 56 yo f who is treated for schizophrenia. Pts is cooperative but denies any pain now, 2 serial ECGs 15 min apart were identical with the current one below. What would you do ?

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Emre Aslanger

@AslangerE

2 years

An easier one. 60 yo male presents with chest pressure. What do you think ?

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Emre Aslanger

@AslangerE

2 years

60 yo male presents with mild but constant mid chest pain. Any comments ?

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Emre Aslanger

@AslangerE

2 years

This was a tough case to decide for me 🥶My wife (42 yo) called from her hospital, complained 15 mins of chest pain radiating to the left axilla, unrelated to exercise, now resolved. I recommended her to have her ECG taken. This is the ECG, what do you think ?

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Emre Aslanger

@AslangerE

2 years

60 something male, presents with chest pain. Should we make a go-through for this ECG ? Any comments ?

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Emre Aslanger

@AslangerE

2 years

50 yo male, presents with 1h crushing chest pain. Any comments ?

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Emre Aslanger

@AslangerE

2 years

Tüm sağlık personelleri için; ambulanstan yoğun bakıma, damar yolu açılmasından İABP takılmasına, EKG’den ilaç dozlarına kadar geniş bir içeriği bulabileceğiniz kitabımız “Kardiyolojide Sağkalım Rehberi” çıktı. Faydalı olması dileğiyle tüm sağlık camiasının birliğine adıyoruz…

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Emre Aslanger

@AslangerE

2 years

71 yo F, presents with 1.5h vague chest pain. Which of these ECGs makes you convinced to go directly cath lab ? 1st, 2nd, both or none ?

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Emre Aslanger

@AslangerE

1 year

45 yo male with a history of inferior MI and RCA stent 7 days ago presents with atypical CP. The first cTnT is 22 ng/L (N<14 ng/L). What do you think ?

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Emre Aslanger

@AslangerE

2 years

Thanks for all answers. Let’s try to analyze this ECG together and reveal the answer.

Emre Aslanger

@AslangerE

2 years

60 yo male presents with mild but constant mid chest pain. Any comments ?

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Emre Aslanger

@AslangerE

2 years

The most educative ECGs are the normal ones. 20 yo f, presents with atypical complaints to the outpatient clinic. Consulted for several findings: (1) arrhythmia?, (2) STD?, (3) short PR?, (4) anything else ? Please share your thoughts on the break-down of this ECG.

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Emre Aslanger

@AslangerE

2 years

50 something male presents with typical pain. Which artery do you think the culprit ? (Sorry for the artifactual tracing, this is the only one before cath)

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Emre Aslanger

@AslangerE

3 years

47 yo male. Stuttering pain for half a day. Now resolved. (Again needs sharp eyes 😊).

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Emre Aslanger

@AslangerE

3 years

(Of course this is not an official endorsement but I believe) Turkish Society of Cardiology will be the first to move to the next step in MI classification.

Turkish Society of Cardiology

@TKDsosyal

3 years

A step by step approach for recognizing subtle coronary artery occlusion during myocardial infarction A new paradigm shift in the dx of STEMI? Read in the latest issue of the #TurkKardiyolDernArs @AslangerE @PendellM @smithECGBlog

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Emre Aslanger

@AslangerE

2 years

Let’s ignite a new discussion on these last two cases. In ECG terminology we have two different coordinate systems: One based on the heart, the other based on the positions of the leads on the chest wall. We unintentionally intermix these and this creates confusion.

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Emre Aslanger

@AslangerE

1 year

Let me restate it: We don't advocate abandoning STEMI because ST segment is useless. We still heavily depend on ST segment in OMI/NOMI paradigm. But, "OMI" reminds the real pathology, indicates it may be a diagnosis independent of ECG and encourages to act accordingly.

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Emre Aslanger

@AslangerE

3 years

53 yo male presents with chest pain. What do you think ?

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Emre Aslanger

@AslangerE

3 years

63 yo male with stuttering chest pain. A very demonstrative sequence to de Winter’s pattern.

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Emre Aslanger

@AslangerE

3 years

55 yo female, 1h chest pain now about to resolve. What do you think ?

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Emre Aslanger

@AslangerE

3 years

32 yo male with undulant chest pain. Do you see a UFO* here ? *undefined (by the guidelines) flow obstruction

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Emre Aslanger

@AslangerE

3 years

67 yo female presents with dizziness. What do you think ?

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Emre Aslanger

@AslangerE

3 years

This is an old one, but wasn't shared here. The 1st ECG in the ER. The patient transferred to CCU with a diagnosis of NSTEMI and the 2nd ECG was obtained. What is happening ?

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Emre Aslanger

@AslangerE

2 years

50 something male presents with CP. ECGs are in order, ~30-60 min apart. Could you tell what is happening here ?

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Emre Aslanger

@AslangerE

2 years

46 yo obese female patient presents with 1.5 hours of pressure-like chest pain radiating to left arm. What do you think and do ?

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Emre Aslanger

@AslangerE

2 years

35 yo male with a history of Fallot tetralogy operation presents with syncope. What do you think ?

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Emre Aslanger

@AslangerE

2 years

24 yo female, presents with "low heart rate" found at job application examination. No symptoms, excellent exercise capacity. What would you do ?

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Emre Aslanger

@AslangerE

2 years

CPR in the Cath Lab… Now online…

CPR in the Cath Lab

A documentary presentation of an interesting cardiopulmonary resuscitation case who was revived with the use of an extraordinary method. The film also includ...

www.youtube.com

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Emre Aslanger

@AslangerE

2 years

What is the sinus rate here ? (also known as "Can leopard change its spots ?")

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Emre Aslanger

@AslangerE

3 years

55 yo male with a prior history of MI and stent (reports not available). Presents with tingling chest pain, dyspnea and a feeling of fever after COVID vaccination. Now pain free. Here is his ECG, what do you think ?

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Emre Aslanger

@AslangerE

2 years

55 yo male presents with crushing 4h chest pain, now halved. First TnT is 256 ng/L. A diagnosis of NSTEMI was done. Do you agree ?

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Emre Aslanger

@AslangerE

1 year

50 something male presents with stuttering chest pain. What do you think ?

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Emre Aslanger

@AslangerE

2 years

35 yo male, presents with atypical chest pain. What do you think ?

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Emre Aslanger

@AslangerE

2 years

Our studies on "OMI/NOMI paradigm" receive “Physician Of The Year Awards - Innovative Internal Medical Sciences Physician Of The Year” from an independent organization @Doktorclubcom . Motivating, but still a long way to go !

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Emre Aslanger

@AslangerE

1 year

These two patients came to the outpatient clinic, one with chest pain the other with check-up purposes. Can you guess which one is which ? And what would you do ?

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Emre Aslanger

@AslangerE

2 years

68 yo male presents to our outpatient clinic with intermittent CP in the last 2 months. How do you interpret this ECG ?

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Emre Aslanger

@AslangerE

1 year

43 yo F, presents with typical chest pain and a though ECG. What would you do ?

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Emre Aslanger

@AslangerE

1 year

An easy one: 60 yo male with a history of Cx stunting two years ago presents with chest pain. His ECG and posterior leads (darker ECG) are shown below. Emergency physician believes this is a NSTEMI as there is no STE in posterior leads. What do you think ?

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Emre Aslanger

@AslangerE

2 years

@smithECGBlog @PendellM Some of our residents thought that "Aslanger E" was a foreign author and they pronounced it like English and described me Ace-len-gear pattern.

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Emre Aslanger

@AslangerE

1 year

An interesting series of ECGs for ECG fans. What do you think ? 54 yo male presents with stuttering central CP. Here is his first ECG.

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Emre Aslanger

@AslangerE

2 years

Thrilled and honored to be a part of Dr. Smith's ECG blog @ @smithECGBlog @Pendell @ekgpress @ECGcases

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Emre Aslanger

@AslangerE

2 years

28 yo male presents with dull chest pain for 4hrs. hsTnT 250 ng/L. What do you think ?

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Emre Aslanger

@AslangerE

3 years

This is an interesting case in many aspects. It will also provide some additional evidence to those who are skeptic about our previous discussion. 56 yo diabetic woman presents with 15 min of chest pain. What do you think ? If you need serial ECGs, I can post.

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Emre Aslanger

@AslangerE

3 years

Today’s ECG challenge. A 50-something, foreign language speaking man seems to complain of chest pain. What do you think ?

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Emre Aslanger

@AslangerE

3 years

45 yo patient presents with stabbing chest pain after a fall. His ECG is as follows. What do you think ?

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Emre Aslanger

@AslangerE

4 years

I believe it is time to abandon the term “STEMI”. Acute coronary occlusion can be predicted with many additional ECG findings. See our latest open-access article at:

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Emre Aslanger

@AslangerE

3 years

Both of these pts were 50 yo male, presented to ER with vague chest pain. What do they have in common and what would you immediately do ?

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Emre Aslanger

@AslangerE

2 years

50 yo male, presents with "stabbing but somewhat dull" left-sided chest pain. What do you think ?

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Emre Aslanger

@AslangerE

3 years

45 yo male presents with new onset palpitation. What would your next move be ?

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Emre Aslanger

@AslangerE

2 years

See our latest research at JAHA (open access):

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Emre Aslanger

@AslangerE

2 years

45 yo male, presents with remitting CP. What do you think of his ECG ?

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Emre Aslanger

@AslangerE

3 years

@sbh0012 @Sagar13desai @AnwarVarghese @KTamirisaMD @akbarul @pramesh0522 @cardio_gotya @drkvarun @aayshacader Another electromechanical association artifact. The problem is foot electrode. This is an extremely common condition, I saw countless examples (many of them misdiagnosed as STEMI, VPBs, pericarditis etc.) since we first defined it in 2012: @YalinKivanc

Electromechanical association: a subtle electrocardiogram artifact - PubMed

Artifacts on electrocardiogram (ECG) can simulate serious cardiac disorders. Although most common ECG artifacts can be easily recognized, in some exceptional situations, some patterns may hide pretty...

pubmed.ncbi.nlm.nih.gov

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Emre Aslanger

@AslangerE

3 years

52 yo male with crushing chest pain for two hours, now diminished but still continuing. What do you think ?

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Emre Aslanger

@AslangerE

3 years

48 yo man, with some vague chest pain. First Tn is negative. What do you think ?

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Emre Aslanger

@AslangerE

3 years

57 yo female, w/o any previous disease except HTN, presents with chest pain. Her ECG is shown below. (Thanks to @m_a_simsek for this case)

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Emre Aslanger

@AslangerE

10 months

Meet Pulsus Aslanger: 🤣🤣

Pulse of Atrioventricular Dissociation

www.ahajournals.org

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Emre Aslanger

@AslangerE

1 year

34 yo male presents with chest pain and arm numbness. His two consequitive ECG 30 min apart are given below. What do you think ? Ps: Digitized by the amazing App @PMcardioBot by @RobertHermanMD

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Emre Aslanger

@AslangerE

2 years

60 something year old man presents with waxing and waning chest pain. What do you think ?

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Emre Aslanger

@AslangerE

2 years

60 something male presents with chest tightness, now partially resolved.

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Emre Aslanger

@AslangerE

2 years

57 yo lady with 3h typical chest pain. Very clear example of you-know-who segment involvement.

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Emre Aslanger

@AslangerE

3 years

Mustafa Emin Çanakçı

@Canakcimustafa

3 years

What a nice introduction!!! Thanks for the article 😇 @iustinianos @PendellM @smithECGBlog

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Emre Aslanger

@AslangerE

2 years

My next post will be a bit different... A movie on an interesting case of resuscitation... Coming soon...

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Emre Aslanger

@AslangerE

2 years

60 something male, w/o any Hx of cardiac disease, presents with 2h of central, burning chest pain. What do you think ?

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Emre Aslanger

@AslangerE

3 years

You will frequently hear this title in the near future. @smithECGBlog @PendellM @BraceyA

The STEMI/NonSTEMI Dichotomy needs to be replaced by Occlusion MI vs. Non-Occlusion MI - PubMed

The STEMI/NonSTEMI Dichotomy needs to be replaced by Occlusion MI vs. Non-Occlusion MI

pubmed.ncbi.nlm.nih.gov

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Emre Aslanger

@AslangerE

3 years

I’d like to share an interesting case step by step. A 62 yo female with SLE presents with crushing chest pain. Here is her first ECG. What is your first guess ?

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Emre Aslanger

@AslangerE

3 years

Thanks for all contributions. The patient presented with orthodromic AVRT. Adenosine caused it to stop but induced AF, so 2nd ECG is preexcited AF. After DC CV ECG showed manifest WPW. THM: Adenosine rarely induces AF, always keep a defibrillator handy when giving adenosine.

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Emre Aslanger

@AslangerE

3 years

56 yo male. Stuttering pain. The last episode has just started seconds ago. What do you think ?

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Emre Aslanger

@AslangerE

2 years

79F with a Hx of previous MI and HF is admitted to the COVID ward for nasal O2 support. She was consulted for a newly developed tachycardia. She denies any symptom and does well. What do you think and what would you do ? (The 1st ECG is admission ECG, 2nd is the current one)

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Emre Aslanger

@AslangerE

2 years

50 something yo male with a history of lung Ca presents with stabbing chest pain on coughing. How is your breakdown ?

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Emre Aslanger

@AslangerE

3 years

I have never seen such a prominent example of 🇿🇦 but on a second look I understood the reason 😊 First diagonal occlusion

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Emre Aslanger

@AslangerE

3 years

This may be too much for some, but not for those who are used to using magnifying glasses here. This time a microscope may be necessary though. 38 yo female presents with typical anginal chest pain. What do you think ?

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Emre Aslanger

@AslangerE

3 years

50 yo male not with MVR but with pressing chest pain now😊 What do you think ?

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Emre Aslanger

@AslangerE

3 years

Back to work after vacation. 70F, 40 p/y tobacco, 3h of CP (with the courtesy of @m_a_simsek ). What do you think ?

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Emre Aslanger

@AslangerE

3 years

38 yo obese patient. Referred for preoperative cardiac evaluation (gastric reduction). Complains intermittent heartburn. What do you think ?

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Emre Aslanger

@AslangerE

3 years

37 yo male with crushing chest pain. Do you have any evidence of acute coronary occlusion on this ECG ?

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Emre Aslanger

@AslangerE

2 years

30 year old male, presents with stuttering chest pain. These two ECGs were taken only one hour apart. Which one is more suspicious for OMI and why ? Thinking about the mechanism will be rewarding.

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Emre Aslanger

@AslangerE

3 years

88 yo male. Prior HT, CABG x 1 (saphenous->LAD, >10 years). He had an inferior MI 3 days ago, treated with a stent (to RCA). On echo LVEF %65, LVH, only basal-mid inferior dyskinesia. After discharge he presents again with chest pain and dyspnea. What are the possibilities?

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Emre Aslanger

@AslangerE

3 years

Although atrial depolarization (Tp) may cause pseudo-STE, its effect is generally mild. Do not directly attribute STE to Tp if P wave amplitude is small and PR is not short. Here are two ECGs from the same patient with inferior MI. Compare with:

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