Ken Grauer, MD

JULY 22, 2023

I see the following: Although there is no long lead rhythm strip — we can see that the rhythm is AFib with a controlled ventricular response ( ie, irregularly irregular rhythm without P waves — and with a heart rate between ~70-110/minute ). Regarding Intervals: There is no PR interval ( since the rhythm is AFib ).

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Blog Chest Pain STEMI AFIB 78

Dr. Smith's ECG Blog

OCTOBER 28, 2023

There was some dyspnea but no chest pain. Tall R wave in lead V1 and/or early transition in the chest leads ( reflecting increased "septal" forces ). WPW Cardiac arrhythmias ( especially AFib ). 23/WCC — 2/21/2020 ). 23/WCC — 2/21/2020 ). 23/WCC — 2/21/2020 ). 23/WCC — 2/21/2020 ).

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Preserved Ejection Fraction Sudden Cardiac Death Chest Pain Heart Failure 57

Dr. Smith's ECG Blog

AUGUST 13, 2020

9 Hours of Chest Pain and Deep Q-waves: Is it too late for Thrombolytics? As per Dr. Smith — this suggests that despite QRS widening, the rhythm in ECG #3 is AFib with a rapid ventricular response. FINAL PEARL #3: When AFib is fast — the rhythm may at first glance look like it is regular. LV Aneurysm?

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Tachycardia AFIB Cardiogenic Shock Myocardial Infarction 52

Dr. Smith's ECG Blog

JANUARY 9, 2024

The patient also has a history of AFib and HFmrEF ( = H eart F ailure with M inimally- R educed E jection F raction ). This patient presented to the ED “after a couple of days of chest discomfort”. For clarity in Figure-1 — I have reproduced and labeled this patient’s initial ECG.

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Tachycardia Electrophysiology Atrial Flutter Ischemia 119

Dr. Smith's ECG Blog

JANUARY 5, 2020

This 60-something with h/o COPD and HFrEF (EF 25%) presented with SOB and chest pain. of all cases, and 62% of Veritas® misdiagnoses). == MY Comment , by K EN G RAUER, MD ( 1/5/2020 ): == This case illustrates a number of important teaching points. The patient in this case presented with dyspnea and chest pain.

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Atrial Fibrillation Tachycardia Arrhythmia Pulmonary 52

Dr. Smith's ECG Blog

JANUARY 26, 2023

and if not — Is the rhythm “irregularly irregular”, as in AFib — or is there a pattern of “regular" irregularity in the form of group beating ? ). This may lead to a series of symptoms similar to “pacemaker syndrome” ( ie, dizziness, fatigue, light-headedness, presyncope/syncope, dyspnea and/or chest pain ). What is the R ate?

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Pacemaker Chest Pain AFIB Blog 52

Dr. Smith's ECG Blog

NOVEMBER 15, 2020

Diagnosis : Extremely slow Atrial flutter == MY Comment , by K EN G RAUER, MD ( 11/15/2020 ): == Some of the most interesting ECG cases I have seen have been picked up “reading through a stack of ECGs” — in the same manner that Dr. Smith picked up today’s case. There was no chest pain — and all troponins were negative.

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Atrial Flutter Cardiomyopathy Chest Pain Arrhythmia 52

Dr. Smith's ECG Blog

FEBRUARY 17, 2023

This patient had many complaints including chest pain. Comment by K EN G RAUER, MD ( 2/11 /2023 ): = Today’s case is from a patient with “many complaints”, including chest pain — and, an ECG that raised concern about acute anterior OMI. Chest pain was just one of these complaints. The ioninzed calcium was 6.5

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Chest Pain Cardiac Arrest STEMI Arrhythmia 52

Dr. Smith's ECG Blog

MARCH 6, 2020

This middle-aged man with no cardiac history but with significant history of methamphetamin and alcohol use presented with chest pain and SOB, worsening over days, with orthopnea. Figure-4: I’ve postulated a laddergram for ECG #3 in Today’s Case ( For more on the use of laddergrams — See My Comment in the February 20, 2020 post ).

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Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2024

1) Very high initial troponin of 45,000 ng/L 2) A full day of chest pain 3) Q-waves on the ECG, with some T-wave inversion Here is one frame of the CT scan which includes the heart: Can you spot the infarct? The November 10, 2020 post — for PTA. The October 17, 2020 post — for a 70-year old woman with " Artifactual VT ".

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Blog Chest Pain Myocardial Infarction Critical Care 63