Aneurysm Pulmonary Tachycardia 
Dr. Smith's ECG Blog
NOVEMBER 17, 2023
Ken (below) is appropriately worried about pulmonary embolism from the ECG. What I had not told him before he made that judgement is that the patient also had ultrasound B-lines of pulmonary edema. LV aneurysm has QS-waves, so this couldn't be LV aneurysm, right? What do you think? This is HIGHLY suspicious for OMI.
Dr. Smith's ECG Blog
APRIL 12, 2013
He was in acute distress from pulmonary edema, with a BP of 180/110, pulse 110. He had diffuse crackles on exam and B-lines on chest ultrasound, and chest x-ray also confirmed pulmonary edema. Here is his ED ECG: There is sinus tachycardia. The hypertension alone is the likely etiology of the pulmonary edema.
HeartRhythm
JULY 30, 2024
Extra-pulmonary vein (PV) triggers have been reported in up to 4.9-15% 1,2 Eliminating identified extra-PV triggers is an important part of an AF ablation procedure after pulmonary vein isolation (PVI) is achieved.3 Extra-pulmonary vein (PV) triggers have been reported in up to 4.9-15%
Dr. Smith's ECG Blog
JANUARY 27, 2024
Smith : Old inferior MI with persistent ST Elevation ("inferior aneurysm") has well-formed Q-waves. In inferior aneurysm, we usually see QR-waves, whereas for anterior aneurysm, we see QS-waves (no R- or r-wave at all!). The patient had a history of ‘NSTEMI’ a decade prior, with an RCA stent.
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.
Dr. Smith's ECG Blog
MARCH 11, 2019
The only time you see this without ischemia is when there is an abnormal QRS, such as LVH, LBBB, LV aneurysm (old MI with persistent STE) or WPW." In such cases, it is common for tachycardia to exaggerate the ST Elevation And, in fact, there was no new acute MI at this visit - troponins did not rise again. Troponin I greater than 1.0
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. There are no Q-waves to suggest old inferior MI, or inferior aneurysm as the etiology of the ST Elevation. She arrived to the ED with a nonrebreather mask. An EKG was immediately recorded.
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