Dr. Smith's ECG Blog
MAY 20, 2024
This EKG is diagnostic of transmural ischemia of the inferior wall. If it is angina, lowering the BP with IV Nitroglycerine may completely alleviate the pain and the (unseen) ECG ischemia. Transmural ischemia (as seen with the OMI findings on ECG) is not very common with demand ischemia, but is possible. Murakami MM.
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
DISCUSSION: The 12-lead EKG EMS initially obtained for this patient showed severe ischemia, with profound "infero-lateral" ST depression and reciprocal ST elevation in lead aVR. The ECG cannot diagnose the etiology of ischemia; it only the presence of ischemia, from whatever etiology. Heart 2011; 97 : 838-843 [link] 14.
Dr. Smith's ECG Blog
JULY 14, 2023
Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. Finally, head-up CPR (which was not used here), makes for better resuscitation.
Ken Grauer, MD
JULY 22, 2023
In 2011 — Niu et al described the presence of an "N-Wave" — or delayed activation wave of the left ventricular basal region. Because this area of the heart is typically supplied by the LCx — this is likely to be the "culprit" artery when N waves are seen as part of the pattern of acute ischemia ( Int J Cardiol 162(2): 107-111, 2013 ).
Dr. Smith's ECG Blog
APRIL 15, 2019
But when the clinical presentation is sepsis, one must entertain the possibility that the ST elevation is due to demand ischemia, or some other process, and exacerbated by tachycardia. In this abstract from 2011, we found that 4%(4 of 99) type 2 MI and 38% of type 1 MI had ST Elevation.
Dr. Smith's ECG Blog
JUNE 1, 2020
Instead, antiarrhythmic drugs such as amiodarone or ß-blockers may be needed — and/or treatment targeted to correcting ischemia. Although IV Mg++ is also indicated as initial treatment of PMVT with a normal QT — it is clearly less likely to respond to IV Mg++, than when the QT interval is prolonged.
Ken Grauer, MD
MARCH 23, 2023
At about this point in the process — I like to take a closer LOOK at the 12-lead tracing, to ensure there is no acute ischemia or infarction that might need immediate attention. What about the 1 2- L ead E CG ? As already established — the QRS complex is narrow in all leads, so the rhythm is supraventricular. The QTc is not overly prolonged.
Expert insights. Personalized for you.
124 
Let's personalize your content