Dr. Smith's ECG Blog

JANUARY 11, 2025

It is a wide complex regular tachycardia at a rate of 120. Is it ventricular tachycardia? I fear that many learners would also not easily recognize where the QRS actually ends, and I fear that some may think that this is ventricular tachycardia due to inability to distinguish QRS from ST segment. The ST Elevation is NOT typical.

Cardiogenic Shock 137

Cardiogenic Shock Chest Pain Tachycardia Cardiac Arrest 137

Dr. Smith's ECG Blog

MARCH 3, 2025

The status of the patients chest pain at this time is unknown : EKG 1, 1300: There is sinus tachycardia and artifact of low and high frequency. However, there is also significant tachycardia , with heart rate of 116, and known hypoxia. She arrived to the ED with a nonrebreather mask. Her blood pressure on arrival was 153/69.

Tachycardia 73

Tachycardia Pulmonary Chest Pain Stenosis 73

Cardiometabolic Health Congress

JANUARY 2, 2025

Landiolol Approval Date: November 22, 2024 Indication: Approved for the treatment of supraventricular tachycardia (SVT). Studies on Supraventricular Tachycardia : 5 studies , a total of 317 adults. Heart rate reduction within 10 minutes : Landiolol: 40%-90%.

Coronary Artery Disease 52

Coronary Artery Disease Stents Stent Innovation 52

Ken Grauer, MD

JANUARY 10, 2025

TiCM is defined as the presence of a reversible form of LV dysfunction due solely to an increase in ventricular rate from any type of frequent or sustained tachycardia ( rapid AFib being the most common precipitating rhythm but TiCM has also been shown to arise from AFlutter, reentry SVT rhythms, ATach, frequent PVCs, episodes of VT ).

Blog 168

Blog Tachycardia Heart Disease AFIB 168

Dr. Smith's ECG Blog

MARCH 6, 2025

Smith comments : Wide complex tachycardia. The differential diagnosis of WCT is: 1) Sinus tachycardia with "aberrancy" (in this case RBBB and LAFB), but there are no P-waves and the QRS morphology is not typical of simple RBBB/LAFB. Also, if the rate is constant, not wavering up and down, it is highly unlikely to be sinus tachycardia.

Tachycardia 95

Tachycardia Dysrhythmia ICU Pulmonary 95

Ken Grauer, MD

MARCH 14, 2025

QUESTION: This tracing was interpreted as sinus tachycardia with some kind of BBB ( B undle B ranch B lock ). ANSWER: There is no Bundle Branch Block because the rhythm is not sinus tachycardia. Thus, one might easily be fooled from Figure-1 into thinking that todays rhythm is sinus tachycardia. What kind of BBB is this?

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Blog Tachycardia Download Heart Disease 98

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). This patient very likely has some form of idiopathic ventricular tachycardia. Of the ventricular outflow tract tachycardias (RVOT-VT) makes up 80-90%.

Tachycardia 72

Tachycardia Arrhythmia Ablation Atrial Flutter 72

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

There was never ventricular fibrillation (VF) or ventricular tachycardia (VT), no shockable rhythm. Here is a similar case: Collapse, Ventricular Tachycardia, Cardioverted, Comatose on Arrival. Agitation, Confusion, and Unusual Wide Complex Tachycardia. There is sinus tachycardia at ~115/minute.

STEMI 88

STEMI Hemorrhage Cardiac Arrest Tachycardia 88

Ken Grauer, MD

MARCH 29, 2025

T wave inversion as seen in ECG #2 is not uncommon following a sustained tachyarrhythmia ( sometimes called a "Memory Effect" or "post-tachycardia" syndrome ). In most cases when not due to a new infarction this post-tachycardia T wave inversion resolves over the ensuing hours ( and almost alwlays within 1-2 days ).

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Blog Tachycardia Cardiac Arrest Download 116

Dr. Smith's ECG Blog

JANUARY 28, 2025

Some OMI have zero ST elevation OMI can happen in young patients with no known medical history == MY Comment , by K EN G RAUER, MD ( 1/24 /2025 ): == There is a lot to be learned from today's post. In Figure-1 I facilitate comparison of the 3 ECGs in today's case by putting them together. This unfortunately is faulty reasoning.

Chest Pain 105

Chest Pain STEMI Hospital Blood Pressure 105

Ken Grauer, MD

JANUARY 2, 2025

In view of the clinical history ( ie, that this patient had a history of longstanding AFlutter but as far as we know, no chest pain ) this ST-T wave change most likely reflects a "memory" effect , in which there will often be ST-T wave abnormalities that persist for hours ( up to a few days ) following a long period of a sustained tachycardia.

Blog 168

Blog Chest Pain Bradycardia Tachycardia 168

Dr. Smith's ECG Blog

JANUARY 24, 2025

Ventricular tachycardia?) This is why you should never wait for troponin to reperfuse when the ECG says "OMI [link] == MY Comment, by K EN G RAUER, MD ( 1/21/2025 ): == Todays case is frustrating because there is no way that 30 hours should have passed until cardiac cath was done. He said it felt like "someone ripped [his] heart out."

Chest Pain 124

Chest Pain STEMI Risk Factors Coronary Artery Disease 124

Dr. Smith's ECG Blog

JANUARY 21, 2025

This ECG was recorded: It is difficult to appreciate P-waves, but I believe this is sinus tachycardia. In Figure-1 Ive labeled ECG #1 , which confirms Dr. Smiths suspicion of sinus tachycardia as the rhythm. BOTTOM Line: The rhythm in today's initial ECG is sinus tachycardia , with some variation in rate. He was put on BiPAP.

Chest Pain 61

Chest Pain STEMI Tachycardia Myocardial Infarction 61

Ken Grauer, MD

FEBRUARY 7, 2025

Awareness of our relative certainty about whether we are dealing with ischemic or idiopathic VT vs some form of SVT vs a WPW-related tachycardia can guide us for deciding when to try vagal maneuvers, electrical cardioversion, or some form of medical therapy ( ie, Adenosine, Amiodarone, Verapamil, -Blocker, or other ).

Blog 101

Blog Heart Disease Download Tachycardia 101

Ken Grauer, MD

MARCH 8, 2025

While its action improves AV conduction it may increase the sinus rate, producing a sinus tachycardia with adverse effect. A DDENDUM # 1 ( 3/8/2025 ) regarding the Term " O MI " The new terminology that I favor adds "OMI" ( = O cclusion-based M yocardial I nfarction ) to the classification of acute MI.

Blog 105

Blog STEMI Download Chest Pain 105

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. If the QRS is prolonged, then the differential includes: 1. Hyperkalemia 2. Other drugs with sodium channel blockade: Tricyclic antidepressants.

Chest Pain 71

Chest Pain Cardiac Arrest Ischemia Sudden Cardiac Death 71

Dr. Smith's ECG Blog

APRIL 9, 2025

2025.110515 [link] Abstract Objective: The administration of amiodarone or lidocaine is recommended during the resuscitation of out-of-hospital cardiac arrest (OHCA) patients presenting with defibrillation-refractory or recurrent ventricular fibrillation or ventricular tachycardia. DOI: 10.1016/j.resuscitation.2025.110515

Defibrillator 63

Defibrillator Cardiac Arrest Myocardial Infarction STEMI 63

Dr. Smith's ECG Blog

MARCH 8, 2025

link] == MY Comment , by K EN G RAUER, MD ( 1/20 /2025 ): == If you Google, Broken Heart Syndrome you will immediately see reference to many pages of Patient Education news briefs and informationals, in which the questions addressed are, Can You Really Die of a Broken Heart? & Dawson, D. Circulation , 145 (13), 10021019.

Cardiomyopathy 75

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 75