Ken Grauer, MD

JULY 9, 2023

Blood was drawn , and the patient was promptly placed in a room to be seen — but on entering, the ED physician found her unresponsive in cardiac arrest. Do you see any indication on this ECG of WHY this patient was about to arrest? Is there any indication on this ECG of WHY this patient shortly after had a cardiac arrest?

Blog 78

Blog Cardiac Arrest Pulmonary AFIB 78

Dr. Smith's ECG Blog

DECEMBER 13, 2024

The 2019 ESC Guidelines for the management of patients with supraventricular tachycardia indicated that IV Amiodarone should not be considered in these populations. Regarding AFib with WPW: The very rapid heart rate and at times extremely short R-R intervals put the patient with AFib and WPW at risk of cardiac arrest from VFib.

AFIB 103

AFIB Atrial Fibrillation Tachycardia Blog 103

Dr. Smith's ECG Blog

JANUARY 8, 2024

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG == MY Comment , by K EN G RAUER, MD ( 12/31 /2023 ): == My only hope about today's tragic case — is that the involved providers learn from mistakes made. KEY Findings in ECG #1 include the following: Sinus tachycardia at ~110/minute.

Chest Pain 70

Chest Pain Pulmonary Embolism STEMI 70

Dr. Smith's ECG Blog

FEBRUARY 27, 2023

Descriptive analysis of the ECG in today's case reveals a regular, narrow tachycardia at ~130/minute , without clear sign of sinus P waves. But the rate is ~130/minute — which is a bit fast for sinus tachycardia. So IF this is sinus tachycardia with a sinoventricular rhythm — then we have to explain WHY the rate is this fast.

Tachycardia 52

Tachycardia Document Blog Bradycardia 52

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. Conclusion: Type II MI probable due to hypoxia and tachycardia from resp arrest and amphetamine use. On arrival to the ED, the patient was diaphoretic, tachycardic.

Tachycardia 52

Tachycardia Ischemia Cardiac Arrest Echocardiogram 52

Dr. Smith's ECG Blog

OCTOBER 25, 2023

ECG is consistent with severe hypokalemia and/or hypomagnesemia causing prolonged QT (QU) at high risk of Torsades (which is polymorphic ventricular tachycardia in the setting of a long QT interval). Polymorphic Ventricular Tachycardia Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management Cardiac Arrest.

Chest Pain 123

Chest Pain Ischemia Cardiac Arrest Blog 123

Dr. Smith's ECG Blog

OCTOBER 20, 2024

This patient is actively dying from a left main coronary artery OMI and cardiac arrest from VT/VF or PEA is imminent! Complete LMCA occlusion is associated with clinical shock and/or cardiac arrest. The arterial blood gas showed a lactic acidosis with a lactate level of 17mmol/L.

Cardiogenic Shock 127

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 127

Dr. Smith's ECG Blog

OCTOBER 8, 2023

Smith: This bizarre ECG looks like a post cardiac arrest ECG with probable acidosis or hyperkalemia in addition to OMI. The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. Below the J-point is marked out showing the ST pathologic deviations. What was the pH and K? Potassium 4,6.

Ischemia 121

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 121

All About Cardiovascular System and Disorders

OCTOBER 26, 2023

Brugada Syndrome: Diagnosis and Risk Stratification Hello friends, this is the modified version of my talk at Indian Heart Rhythm Society Conference, New Delhi, 2023, on Brugada Syndrome. Hope you will enjoy this session. Type 2/3 ECG which gets converted to type 1 pattern with sodium channel blockers have 2 points.

Sudden Cardiac Death 52

Sudden Cardiac Death Atrial Fibrillation Electrophysiology Arrhythmia 52

Dr. Smith's ECG Blog

APRIL 9, 2025

A retrospective 'target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. Add to this the sobering clinical reality of how difficult it is to get objective, controlled, prospective data in the emergency situation of cardiac arrest and life-threatening arrhythmias.

Defibrillator 62

Defibrillator Cardiac Arrest Myocardial Infarction STEMI 62

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

There was never ventricular fibrillation (VF) or ventricular tachycardia (VT), no shockable rhythm. The patient was unconscious BEFORE the cardiac arrest, at the same time that she had strong pulses. Therefore, cardiac arrest is NOT the etiology of the coma. There is sinus tachycardia at ~115/minute.

STEMI 88

STEMI Hemorrhage Cardiac Arrest Tachycardia 88

Dr. Smith's ECG Blog

JANUARY 13, 2025

Drug toxicity , especially diphenhydramine , which has sodium channel blocking effects, and also anticholinergic effects which may result in sinus tachycardia, hyperthermia, delirium, and dry skin. Unexplained cardiac arrest or documented VF/polymorphic VT: +3 3. Unexplained sudden cardiac death (3 categories) (+0.5 - +2) 4.

Chest Pain 70

Chest Pain Cardiac Arrest Ischemia Sudden Cardiac Death 70

Dr. Smith's ECG Blog

JANUARY 21, 2023

The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy. 2004 = My Comment by K EN G RAUER, MD ( 1/21 /2023 ): = I thought today's case by Drs. The final letter in the SLOWED mnemonic is " D " for "Dead" ( resulting from VT/VF or asystolic cardiac arrest ).

STEMI 52

STEMI Bradycardia Arrhythmia Cardiac Arrest 52