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The American Journal of Emergency Medicine 2015; 33(6):786-790. Acute MI per se usually does not depress cardiac function and bloodpressure enough to cause syncope ( Mostafa et al — J Com Hosp Intern Med Perspect 13(4):9-12, 2023 - ). link] So I responded with these words: Smith : "There are QS waves, which suggest old MI.
Systemic vascular resistance falls, but slight to moderate increase in bloodpressure can occur due to the increased cardiac output. But there is significant rise in bloodpressure leading to pressure overload to the left ventricle. 2015 Apr;16(4):353. Eur Heart J Cardiovasc Imaging.
PVCs N ot generally considered abnormal ECG findings: Isolated PAC, First Degree AV Block, Sinus bradycardia at a rate of 35-45, and Nonspecific ST-T abnormalities (even if different from a previous ECG). Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful.
Patient 2 : 55 year old with 5 hours of chest pain radiating to the shoulder, with nausea and shortness of breath ECG: sinus bradycardia, normal conduction, normal axis, normal R wave progression, no hypertrophy. Smith : The fact that the ECG did not evolve is further proof that this was the baseline ECG.
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