Remove 2018 Remove Cardiac Arrest Remove Electrocardiogram
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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Can J of Cardiol 2018, 34: 132-145 Here are some other cases: LVH, LBBB, RBBB, and RVH may manifest ST depression without any ischemia! Incidence of an acute coronary occlusion.

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Another Inadequate Paper Published on Triage ECGs, whose Conclusions Need Scrutiny.

Dr. Smith's ECG Blog

The utility of the triage electrocardiogram for the detection of ST-segment elevation myocardial infarction. October 2018. Given the dire consequences of missing a STEMI or OMI, including cardiac arrest (see cases below), $5700 is extremely cheap. This paper was just published: Noll S. Am J Emerg Med 36(10):1771-1774.

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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Heart Rhythm, 13(7): 1515-1520. [2]: Circulation, 117, 1890–1893. [3]: Brugada electrocardiographic pattern induced by fever.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Heart Rhythm, 13(7): 1515-1520. [2]: Circulation, 117, 1890–1893. [3]: Brugada electrocardiographic pattern induced by fever.

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A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?

Dr. Smith's ECG Blog

Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep. Heart Rhythm 2018. We repeated the ECG: Brugada pattern is mostly resolved. Studies have shown a higher prevalence of BrS in febrile patients compared to nonfebrile ones.