Remove 2011 Remove Bradycardia Remove Tachycardia
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Tachycardia, fever to 105, and ischemic ST Elevation -- a Bridge too Far

Dr. Smith's ECG Blog

Here was his initial ED ECG: There is sinus tachycardia at a rate of about 140 There is profound ST Elevation across all precordial leads, as well as I and aVL. I said I think there is a fixed stenosis in the LAD and the tachycardia and stress caused a type 2 STEMI.

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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

This progressed to electrical storm , with incessant PolyMorphic Ventricular Tachycardia ( PMVT ) and recurrent episodes of Ventricular Fibrillation ( VFib ). There was no evidence bradycardia leading up to the runs of PMVT ( as tends to occur with Torsades ). He required multiple defibrillations within a period of a few hours.

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QT Correction Formulas Compared to The Rule of Thumb ("Half the RR")

Dr. Smith's ECG Blog

The rule of thumb is less accurate, and the risk is higher because a long QT in the presence of bradycardia ("pause dependent" Torsades) predisposes to Torsades. 6) Use a different rule of thumb for bradycardia : Manually approximate both the QT and the RR interval. 3) At heart rates below 60, far more caution is due. which is 0.6

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Acute coma, then Sudden PEA arrest in front of paramedics, with STEMI?

Dr. Smith's ECG Blog

There was never ventricular fibrillation (VF) or ventricular tachycardia (VT), no shockable rhythm. Here is a similar case: Collapse, Ventricular Tachycardia, Cardioverted, Comatose on Arrival. Agitation, Confusion, and Unusual Wide Complex Tachycardia. There is sinus tachycardia at ~115/minute.

STEMI 88
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Electrical instability in a healthy 50 year old. How to manage?

Dr. Smith's ECG Blog

During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). Below in Figure-5 is a 10-minute continuous lead II recording on oral Flecainide, now showing sinus bradycardia without a single PVC! Potassium and magnesium serum levels were normal.