Dr. Smith's ECG Blog

NOVEMBER 17, 2023

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? LV aneurysm has QS-waves, so this couldn't be LV aneurysm, right? Here is my interpretation: There is sinus rhythm with RBBB.

Aneurysm 126

Aneurysm Stents Stent Chest Pain 126

Dr. Smith's ECG Blog

OCTOBER 26, 2010

He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. He had this ECG recorded. Are the lungs clear?

STEMI 52

STEMI Cardiogenic Shock Tachycardia Aneurysm 52

Dr. Smith's ECG Blog

APRIL 12, 2013

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 amount of ST elevation and depression is slightly less than on the ECG above, but there is also no tachycardia, which tends to exaggerate ST deviation.

STEMI 52

STEMI Pulmonary Stents Stent 52

Dr. Smith's ECG Blog

OCTOBER 17, 2024

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. As for the ECG, it could represent OMI, but RBBB is also a clue that it may be PE. As per Dr.

Chest Pain 75

Chest Pain STEMI Pulmonary Embolism 75

Dr. Smith's ECG Blog

APRIL 8, 2015

Look for Vascular Etiology -- think of these while doing H and P: --Bleeding: ruptured AAA, GI bleed, ruptured ectopic pregnancy, other spontaneous bleed such as mesenteric aneurysms. Most physicians will automatically be worried about these symptoms. Good History and Physical exam, including a. orthostatic vitals b. FHx of sudden death.

Arrhythmia 52

Arrhythmia Outcomes Risk Factors Chest Pain 52

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.

Tachycardia 74

Tachycardia Pulmonary Chest Pain Stenosis 74