Dr. Smith's ECG Blog

NOVEMBER 25, 2022

Blunt Trauma in a Child 40-something male in a head-on Motor Vehicle Collision and Splenic Injury == MY Comment, by K EN G RAUER, MD ( 10/10 /2022 ): == Highly interesting post by Dr. Smith regarding a 30-something male with multiple injuries from a motor vehicle accident. What are the ECG Findings of Cardiac Contusion?

Arrhythmia 52

Arrhythmia Blog Chest Pain Cardiac Arrest 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

It is apparently fortunate that she had a cardiac arrest; otherwise, her ECG would have been ignored. Then she began complaining of severe dizziness and quickly went into ventricular fibrillation and resuscitation was initiated by hospital staff. She was defibrillated and resuscitated. N Engl J Med [Internet] 2013;368(21):2004–13.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Comment by K EN G RAUER, MD ( 11/28 /2022 ): = Today's case is remarkable for the presence of 2 important ECG findings: i ) Low Voltage ; and , ii ) Electrical Alternans. Alternation in ST segment appearance ( or in the amount of ST elevation or depression ) — is often linked to ischemia. As per Drs.

Tachycardia 40

Tachycardia Pericarditis Ultrasound Blood Pressure 40

Ken Grauer, MD

JUNE 27, 2024

He developed cardiac arrest shortly after the ECG in Figure-1 was recorded. As reviewed by Almarzuqi et al ( Vasc Health Risk Mgmt 18:397-406, 2022 ) — Potential Causes of Bidirectional VT include: Digitalis toxicity. Acute myocardial ischemia. Cardiac Sarcoidosis. Primary Cardiac Tumors and/or Cardiac Metastasis.

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Blog Cardiac Arrest Sudden Cardiac Death Tachycardia 159

Dr. Smith's ECG Blog

OCTOBER 10, 2022

In terms of ischemia, there is both a signal of subendocardial ischemia (STD max in V5-V6 with reciprocal STE in aVR) AND a signal of transmural infarction of the inferior wall with Q wave and STE in lead III with reciprocal STD in I and aVL. He had multiple cardiac arrests with ROSC regained each time.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52

Dr. Smith's ECG Blog

JUNE 23, 2024

This was interpreted by the treating clinicians as not showing any evidence of ischemia. The above said — it may prove insightful to take another look at the Wellens' Syndrome case instantly recognized by Dr. Smith in the August 12, 2022 post in Dr. Smith’s ECG Blog. Here is his presenting ECG: ECG 1, t = 0 What do you think?

Chest Pain 118

Chest Pain Cardiac Arrest Sudden Cardiac Death Blog 118

Dr. Smith's ECG Blog

JULY 21, 2024

There is no definite evidence of acute ischemia. (ie, Simply stated — t he patient was having recurrent PMVT without Q Tc prolongation, and without evidence of ongoing transmural ischemia. ( Some residual ischemia in the infarct border might still be present. Both episodes are initiated by an "R-on-T" phenomenon.

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

DAIC

JANUARY 23, 2024

mg reduced the risk of cardiovascular death, MI or heart attack, ischemic stroke, or ischemia-driven coronary revascularization by 31% compared with placebo.34 Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association [published correction appears in Circulation. 2022 Sep 6;146(10):e141].

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Cardiovascular Disease Heart attacks Heart Attack Coronary Artery Disease 111

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

L/min, BP 107/65 mm Hg, HR 71 bpm LVEF 45%, no wall motion abnormality The patient had a complete neurologic recovery, proving once again that the patient is not dead until he/she is warm and dead. == MY Comment by K EN G RAUER, MD ( 2/8/2022 ): == I thought this to be an intriguing case for a number of reasons.

Cardiac Arrest 40

Cardiac Arrest Bradycardia Chest Pain Ischemia 40

Dr. Smith's ECG Blog

JULY 22, 2023

The reason we continue to periodically review cases of Brugada Phenocopy — is that this entity is still overlooked, as it was in today's case ( See My Comment at the bottom of the page in the May 5, 2022 post — and in the November 25, 2022 post of Dr. Smith's ECG Blog — among other cases of Brugada Phenocopy ).

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Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 92

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. 2022 Mar;8(3):386-405. Spontaneous type 1 ECG has the highest number of points at 3.5, 2001 Oct 1;1(1):6-11.

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Sudden Cardiac Death Atrial Fibrillation Electrophysiology Arrhythmia 52

Dr. Smith's ECG Blog

MAY 5, 2022

Steve, what do you think of this ECG in this Cardiac Arrest Patient?" A woman in her 50s with dyspnea and bradycardia A patient with cardiac arrest, ROSC, and right bundle branch block (RBBB). HyperKalemia with Cardiac Arrest. The April 17, 2022 post ( Leads V1,V2 placed too high ).

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 52

Dr. Smith's ECG Blog

JANUARY 13, 2025

Unexplained cardiac arrest or documented VF/polymorphic VT: +3 3. Unexplained sudden cardiac death (3 categories) (+0.5 - +2) 4. Among potential conditions that may produce Brugada Phenocopy are infarction and ischemia. Ischemia or infarction. Cardiac arrest. Clinical History 2.a. Family History 3.a.

Chest Pain 71

Chest Pain Cardiac Arrest Ischemia Sudden Cardiac Death 71

Dr. Smith's ECG Blog

APRIL 16, 2025

Discussion: This patient was very lucky that she had a doctor who understood her initial ECG, advocated for her, performed serial ECGs, and that her serial ECGs happened to have temporary lack of RBBB which reduces the complexity of the ischemia interpretation. Plus recommendations from a 5-member panel on cardiac arrest.

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Chest Pain STEMI Tachycardia Cardiac Arrest 100

Dr. Smith's ECG Blog

JANUARY 11, 2025

The ECG shows sinus tachycardia, RBBB+LAFB, and signs of anterolateral acute transmural ischemia (most likely due to acute coronary occlusion), with concordant STE in I and aVL, inappropriate STE in V4-6 (though limited a bit by motion, still definite). Plus recommendations from a 5-member panel on cardiac arrest.

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Cardiogenic Shock Chest Pain Tachycardia Cardiac Arrest 137

Dr. Smith's ECG Blog

JANUARY 21, 2023

Occurrence of “J Waves” in 12-Lead ECG as a Marker of Acute Ischemia and Their Cellular Basis. Can J Cardiol 2022 Kukla P, Jastrezebski M, Praefort W. Occurrence of "J waves" in 12-lead ECG as a marker of acute ischemia and their cellular basis. A prospective evaluation of the electrocardiogr aphic manifestations of hypothermia.

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STEMI Bradycardia Arrhythmia Cardiac Arrest 52