Dr. Smith's ECG Blog

JANUARY 17, 2023

A 60 year old with chest pain presented to the ED. In this case, lead I does not look bizarre, but all other leads do. == N OTE : The reasons I especially liked today's case are: i ) The patient presented with chest pain — so the importance of distinguishing artifact from reality can not be overstated! —

Chest Pain 52

Chest Pain Physiology Blog Electrophysiology 52

Ken Grauer, MD

SEPTEMBER 22, 2023

Impression: In this middle-aged man with palpitations and dyspnea, but no chest pain — I suspect that the T wave peaking and slight, upward-sloping chest lead ST elevation represent a repolarization variant. The February 11, 2020 post ( LA-RA reversal ). The March 18, 2020 post ( LA-RA reversal ).

Blog 176

Blog Chest Pain Bradycardia Physiology 176

Ken Grauer, MD

APRIL 18, 2023

Figure-1: The initial ECG in today's case — obtained from a 50-year old man with new chest pain. ( In contrast — it is EASY to overlook L A- L L reversal — because the ECG picture seen with this type of lead reversal does not immediately stand out as physiologically “off”. The February 11, 2020 post ( LA-RA reversal ).

Blog 78

Blog STEMI Chest Pain Physiology 78

Dr. Smith's ECG Blog

JANUARY 9, 2024

AV synchrony and physiologic ventricular depolarization the hemodynamics improved. Lowering the back up rate (LRL) of the ICD/pacer allowed for an intrinsic rhythm with physiologic AV conduction and normal AV synchrony with resultant increase in stroke volume and cardiac outpt.

Tachycardia 118

Tachycardia Electrophysiology Atrial Flutter Ischemia 118

Dr. Smith's ECG Blog

NOVEMBER 8, 2022

The patient had come to the ED for SOB, but without any chest pain. Global hypokinesis with possible regional wall motion abnormality-inferior & inferolateral Compared to the Echo from 10/2020, there has been a significant interval change: 1. Therefore, as many as 11 of the 12 leads can look bizarre.

Article 52

Article Chest Pain Blog Myocardial Infarction 52

Dr. Smith's ECG Blog

FEBRUARY 28, 2020

And some similar ECGs from Pulmonary Embolism: A young woman with altered mental status and hypotension An elderly woman transferred to you for chest pain, shortness of breath, and positive troponin - does she need the cath lab now? It just doesn’t make physiologic sense to have deep T wave inversion in V1 and V3, but not in V2.

Chest Pain 52

Chest Pain Pulmonary Tachycardia Embolism 52

Dr. Smith's ECG Blog

FEBRUARY 12, 2023

There was no chest pain. I’ve reviewed My Take on the ECG diagnosis of RVH on a number of occasions in Dr. Smith’s ECG Blog ( See My Comment at the bottom of the page in the March 6, 2022 and September 1, 2020 posts , to name just 2 ). But today's patient had no chest pain. How Does this Apply to Today’s Case?

Pulmonary 40

Pulmonary Chest Pain Hypertension Tricuspid 40