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Here is his ED ECG: There is bradycardia with a junctional escape. Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia. For review — GO TO: The June 4, 2018 post ( LA-LL reversal ). The July 29, 2018 post ( LA-RA reversal ). The November 4, 2018 post ( Leads V1,V2 misplacement ).
There is sinus bradycardia with one PVC. The ways to tell for certain include intravascular ultrasound (to look for extra-luminal plaque with rupture) or "optical coherence tomography," something I am entirely unfamiliar with. She then had a 12-lead: What do you think?
Am J Cardiol 2018; 122(8):1303-1309. Patient presentation is important This was a 60-something with acute chest pain: There is sinus bradycardia at a rate of 44. In case you were wondering about the T-waves and bradycardia, the K was normal. Why bradycardia? In summary: At a cutpoint of 17.0, it is 97% sensitive.
Her bedside cardiac ultrasound was normal We decided to cardiovert her since the time of onset was very recent. Baseline bradycardia in endurance athletes limits the use of ß-blockers. For more on SSS — See My Comment at the bottom of the page in the July 5, 2018 post in Dr. Smith’s ECG Blog.
Regardless of further evaluation, she should avoid bradycardia, AV nodal blockers, Na channel blockers, and fevers. --If A bedside cardiac ultrasound revealed grossly normal to hyperdynamic systolic function with no obvious areas of wall motion abnormalities. Heart Rhythm 2018. y (3 of 88, 43.6 ± 37.4
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