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IMPRESSION: The finding of sinus bradycardia with 1st-degree AV block + marked sinus arrhythmia + the change in PR interval from beat #5-to-beat #6 — suggests a form of vagotonic block ( See My Comment in the October 9, 2020 post in Dr. Smith's ECG Blog ). Initial high sensitivity troponin I returned at 6ng/L (normal 0.20
Complete left bundle branch block (CLBBB)-like QRS morphology of right ventricular pacing at pacemaker implantation satisfying the American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society criteria of CLBBB was associated with development of pacing induced cardiomyopathy.
A 50-something male with unspecified history of cardiomyopathy presented in diabetic ketoacidosis (without significant hyperkalemia) with a wide complex tachycardia and hypotension. The fact that he has a cardiomyopathy argues for a more typical ventricular tachycardia, as does the absence of rSR' in lead V1. It is regular.
The patient was diagnosed with stress cardiomyopathy. Widespread T wave inversions and prolongation of the QT interval is not uncommon in Takotsubo cardiomyopathy. The QTc then gradually shortened over the course of several days as is usual for stress cardiomyopathy. Potassium was 4,8 mmol/l. ( ref 3,5-4,6 mmol/l ).
The granulomatous inflammation affects the heart, causing an infiltrative cardiomyopathy The most common manifestations of cardiac sarcoidosis are atrioventricular (AV) block and ventricular tachyarrhythmias (VT). Lung involvement is the typical presentation. Cardiac sarcoidosis (CS) is seen in ~10% of patients with sarcoidosis.
plaque disruption), the T waves still manifest markings of a previous state of suboptimal coronary flow that resolved: Type II supply-demand mismatch in the setting of extreme bradycardia. LBBB is typically the result of preexisting hypertrophy, ischemic heart disease, or cardiomyopathy. 5] Isnard, R. & Pousset, F. 6] Tabrizi, F.,
As always, takotsubo cardiomyopathy and focal pericarditis can mimic OMI, but takotsubo almost never mimics posterior MI, and both are diagnoses of exclusion after a negative cath. And a complication. == MY Comment by K EN G RAUER, MD ( 10/11/2020 ): == It cannot be stated any clearer than what Dr. Meyers states above. Is that normal?
There is also STE in V1 which is diagnostic of right ventricular OMI in this situation , and partly explains the syncope and hypotension (along with the bradycardia). For more on the ECG diagnosis and consequences of acute RV MI Check out My Comment in July 19, 2020 post and the August 2, 2024 post). This is not the case.
This ECG shows a sinus bradycardia with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, normal R-wave progression, normal voltages. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. Internat J Arrhyth 2020 Uesako H, Fukikawa H, Hashimoto S, et al. As per Drs.
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