Remove 2012 Remove Bradycardia Remove Ischemia
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Normal angiogram one week prior. Must be myocarditis then?

Dr. Smith's ECG Blog

The ECG does not show any definite signs of ischemia. Uncontrolled coronary spasm may be associated with serious arrhythmias , including cardiac arrest ( Looi et al — Postgrad Med, 2012 ; Tan et al — Eur Heart J Case Rep, 2018 ; Chevalier et al — JACC, 1998 ; Rodriguez-Manero — EP Europace, 2018 ).

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Should we activate the cath lab? A Quiz on 5 Cases.

Dr. Smith's ECG Blog

Remember, in diffuse subendocardial ischemia with widespread ST-depression there may b e ST-E in lead s aVR and V1. There are well formed R-waves with good voltage/amplitude which is uncommon for ischemia. The ECG does not show any signs of ischemia. True Positive ECG#2 : Also sinus rhythm. There is ST depression in V1.

Ischemia 114
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Unconscious + STEMI criteria: activate the cath lab?

Dr. Smith's ECG Blog

This ECG shows a sinus bradycardia with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, normal R-wave progression, normal voltages. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. There is marked sinus bradycardia. What do you think? Pacing Clin Electrophysiol.

STEMI 52
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A Middle-Aged male with Chest Pain and an Unusual ECG

Dr. Smith's ECG Blog

Followup ECG: No Change Absence of evolution is the best evidence against ischemia as the etiology. I was taught that the tell-tale sign of ischemia vs an electrical abnormality was in the hx, i.e. chest pain for the ischemia and potential syncope for brugada. Ischemia/infarction. Bradycardia. Hypothermia.

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What is strange about this paroxysmal atrial fibrillation in an otherwise healthy patient? And what happened after giving ibutilide?

Dr. Smith's ECG Blog

IF the Patient is Younger and Athletic: The mechanism of AFib in younger, athletic individuals is often heavily influenced by increased vagal tone ( Rao and Shipon — ACC, 2019 — and — Calvo et al — Br J Sports Med, 2012 ). Baseline bradycardia in endurance athletes limits the use of ß-blockers.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Circulation, 117, 1890–1893. [3]: 3]: Lamelas P, Labadet C, Spernanzoni F, Lopez Saubidet C, and Alvarez PA. Brugada electrocardiographic pattern induced by fever. World Journal of Cardiology, 4(3): 84-86. [4]: 4]: Antzelevitch C and Brugada R.