2020 AFIB Chest Pain 
Dr. Smith's ECG Blog
DECEMBER 26, 2023
I went to the patient's chart: Elderly woman with stuttering chest pain and SOB, and dizziness. For more on Giant T waves — See My Comment at the bottom of the page in the June 22, 2020 and September 19, 2022 posts in Dr. Smith's ECG Blog ). WPW Cardiac arrhythmias ( including AFib ). What do you think now?
Dr. Smith's ECG Blog
JULY 7, 2023
An 80-something woman who presented with chest pain and dyspnea. That said — QOH is already highly sophisticated and accurate in her assessment of ECGs from acute chest pain patients, in which the ECG is not complicated by uncommon OMI mimics. After all, this patient did also present with chest pain. ) — See below.
Ken Grauer, MD
JANUARY 13, 2024
On the other hand — the ST elevation seen in lead V1 is perfectly consistent with LVH and LV "strain" ( ie, The shape of this ST-T wave in lead V1, in association with the deep S wave in this lead — is a mirror-image opposite picture of the typical expected appearance of LVH with "strain" in a lateral chest lead ).
Dr. Smith's ECG Blog
SEPTEMBER 18, 2024
Diagnosis : Atrial flutter with 1:1 conduction, with fast AV conduction made possible by sympathetic drive of exercise On arrival, we obtained another 12-lead: Unremarkable Further history: One month history of shortness of breath on exertion, denies palpitations, chest pain, orthopnea, leg swelling.
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 ).
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?
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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