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Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

An initial electrocardiogram (ECG) is provided below. Again, see Ken's discussion below) Discussion continued The absence of pace spikes suggests this is not a pacemaker/ICD-related rhythm in this patient with an ICD. The patient was promptly admitted to the hospital for further evaluation. What do you think? What is the rhythm?

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. Family history of sudden death at age less than 40 — Negative predictors : —pacemaker, pre- or near- syncope only Workup (Smith opinion from literature) Always evaluate with: 1. Baumann, B.