Ken Grauer, MD

FEBRUARY 28, 2023

The ECG and long lead II rhythm strip in Figure-1 — was obtained from a COVID positive patient with persistent tachycardia not responding to Diltiazem. Figure-1: The initial ECG — obtained from a patient with persistent tachycardia. ( Hypoxic injury ( from pneumonia or other acute pulmonary complication ).

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Dr. Smith's ECG Blog

OCTOBER 17, 2024

Smith comment: before reading anything else, this case screamed pulmonary embolism to me. I would do bedside ultrasound to look at the RV, look for B lines as a cause of hypoxia (which would support OMI, and argue against PE), and if any doubt persists, a rapid CT pulmonary angiogram. There is sinus tachycardia at ~100/minute.

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Chest Pain STEMI Pulmonary Embolism 77

Dr. Smith's ECG Blog

FEBRUARY 28, 2020

My answer: "This is classic for PE, but it can also be present in any hypoxia due pulmonary hypoxic vasoconstriction and resulting acute pulmonary hypertension and acute right heart strain. Tachycardia (or nearly) 2. An ECG was texted to me (Smith) without any clinical information: What did I say? This is NOT Wellens.

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Dr. Smith's ECG Blog

AUGUST 14, 2023

The bedside echo showed a large RV (Does this mean there is a pulmonary embolism as the etiology?) When you suspect pulmonary embolism due to large RV on POCUS, always look for right axis deviation and a large R-wave in V1 because the large RV may be entirely due to chronic RVH, not acute PE. Here is his triage ECG: What do you think?

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Dr. Smith's ECG Blog

OCTOBER 28, 2023

Further ultrasound showed no B-lines (no pulmonary edema). 23/WCC — 2/21/2020 ). 23/WCC — 2/21/2020 ). 23/WCC — 2/21/2020 ). 23/WCC — 2/21/2020 ). The heart rate is too fast for this poor filling. Preload must be increased and the heart rate slowed in order to allow more LV filling.

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Preserved Ejection Fraction Sudden Cardiac Death Heart Failure Chest Pain 60

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

and the patient was converted to veno-venous (V-V) ECMO due to persistent pulmonary insufficiency. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury. medRxiv [Internet] 2020;Available from: [link] 8.

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Ken Grauer, MD

JULY 9, 2023

ECG Blog #65 — for an example of MAT in a patient with chronic pulmonary disease ( plus more on the differential diagnosis of MAT ). These cases provide insight to assessment for MAT: The January 5, 2020 post in Dr. Smith’s ECG Blog — for an example of MAT. ECG Blog #199 and ECG Blog #366 — for Review of M AT.

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Blog Cardiac Arrest Pulmonary AFIB 78

Dr. Smith's ECG Blog

JULY 27, 2023

His prehospital ECG showed "inferior" ST depression and high voltage, with tachycardia. I suspected no OMI, that this could be due to LVH plus tachycardia. The estimated pulmonary artery systolic pressure is 29 mmHg + RA pressure. On arrival to the ED, the patient was diaphoretic, tachycardic. and had dilated pupils.

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All About Cardiovascular System and Disorders

OCTOBER 26, 2023

They include myocardial ischemia, acute pericarditis, pulmonary embolism, external compression due to mass over the right ventricular outflow tract region, and metabolic disorders like hyper or hypokalemia and hypercalcemia. 2020 Sep;31(9):2474-2483. J Cardiovasc Electrophysiol. Gourraud JB, Barc J, Thollet A, Le Marec H, Probst V.

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Dr. Smith's ECG Blog

NOVEMBER 28, 2022

The ECG shows sinus tachycardia, a narrow, low voltage QRS with alternating amplitudes, no peaked T waves, no QT prolongation, and some minimal ST elevation in II, III, and aVF (without significant reciprocal STD or T wave inversion in aVL). It is difficult to tell if there is collapse during diastole due to the patient’s tachycardia.

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