Dr. Smith's ECG Blog

JANUARY 23, 2024

Shortly after isoprenalin infusion was initiated, there were short runs of ventricular tachycardia. Extensive conduction system abnormalities can have various causes (ischemia, genetic, infectious, amyloid, etc). During the next 24 hours, she experienced periods of complete AV block with a ventricular escape rhythm in the 20s.

Tachycardia 88

Tachycardia Arrhythmia Heart Disease Sudden Cardiac Death 88

Dr. Smith's ECG Blog

NOVEMBER 22, 2023

This is ischemic ST depression, and could be due to increasing tachycardia, with a heart rate over 130, but that is unlikely given that the patient is now complaining of crushing chest pain and that there was tachycardia all along. They agreed ischemia was likely in the setting of demand given DKA and infection.

Chest Pain 108

Chest Pain Ischemia Echocardiogram Myocardial Infarction 108

EMS 12-Lead

APRIL 21, 2022

There is appreciable STE aVR with near-global STD that appropriately maximizes in Leads II and V5, and thus suggesting a circumstance of generic, diffusely populated, circumferential subendocardial ischemia versus occlusive coronary thrombus. [1] There is evolution from Wellens Pattern A to Pattern B, now inclusive of V6.

Ischemia 52

Ischemia Myocardial Infarction Blog Coronary Angiogram 52

Dr. Smith's ECG Blog

AUGUST 17, 2022

ACUTE MI (I allowed Acute MI to be in the report because I knew there would be an elevated troponin from ischemia, which is the definition of acute MI -- but in this case it would most likely be a Type 2 MI from tachycardia) There is also LA-RA lead reversal. The November 27, 2021 post ( LA-RA reversal ).

Atrial Fibrillation 52

Atrial Fibrillation Ischemia AFIB Tachycardia 52

Dr. Smith's ECG Blog

JULY 21, 2024

This progressed to electrical storm , with incessant PolyMorphic Ventricular Tachycardia ( PMVT ) and recurrent episodes of Ventricular Fibrillation ( VFib ). There is no definite evidence of acute ischemia. (ie, Some residual ischemia in the infarct border might still be present.

Arrhythmia 118

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 118

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

There is a run of polymorphic ventricular tachycardia — which given the QT prolongation, qualifies as Torsades de Points ( TdP ). This patient was having recurrent episodes of polymorphic ventricular tachycardia with an underlying long QT interval ( = Torsades des Pointes ). ECG #2 Interpretation of ECG #2: Underlying sinus rhythm.

Tachycardia 108

Tachycardia Blog Sudden Cardiac Death Arrhythmia 108

EMS 12-Lead

APRIL 28, 2022

Initial vital signs include: NIBP 99/58 HR 150-160 (trend) RR 10 (spontaneous, but shallow) SpO2 86 (RA) BBS CTA The initial rhythm strip is attached: Figure 1 There is a wide complex tachycardia of varying morphology, amplitude, and R-R cycle length. Chapter 10: Recurrent Ventricular Tachycardia (pg. 2] Viskin, S., 4] Surawicz, B.

Tachycardia 52

Tachycardia AFIB Coronary Artery Bypass Graft Arrhythmia 52