Dr. Smith's ECG Blog

FEBRUARY 6, 2024

The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. The Initial ECG in Today's Case: As per Dr. Meyers — the initial ECG in today's case shows sinus tachycardia with bifascicular block ( = RBBB/LAHB ). Sinus Tachycardia ( common in any trauma patient. ).

Tachycardia 115

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 115

EMS 12-Lead

APRIL 9, 2024

An increase in myocardial oxygen demand due to tachycardia, elevated ventricular afterload (BP or Aortic stenosis), increased wall stretch, or a decrease in oxygen supply due to hypotension, anemia, hypoxia, sepsis, or a combination of all of the above. Type II ischemia.

Ischemia 116

Ischemia Stenosis Chest Pain Coronary Artery Disease 116

Dr. Smith's ECG Blog

JUNE 27, 2024

EMS reports intermittent sinus tachycardia and bradycardia secondary to some type of heart block during transport. It is hard to make out P waves but you can see them best in V2, and notches in the T waves in other leads - this is a sinus tachycardia with a very long PR interval indicating first degree block.

Blog 120

Blog Pacemaker Bradycardia Tachycardia 120

Dr. Smith's ECG Blog

OCTOBER 20, 2024

Post PCI an intra-aortic balloon pump (IABP) was placed and a combination of norepinephrine and dobutamine was needed to maintain perfusion pressures. The image quality is not the best, but you can see the subtotal occlusion of the left main artery. Below is a still image with the red arrow indicating the subtotal LMCA stenosis.

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Journal of Cardiovascular Electrophysiology

MARCH 11, 2025

We report our initial experience in using this catheter for the treatment of outflow premature ventricular contractions (PVCs) or repetitive non-sustained monomorphic ventricular tachycardias (VTs). The DTA parameters were adjusted to a target-temperature of 60C with 50W power.

Ablation 40

Ablation Arrhythmia Atrial Fibrillation Tachycardia 40

Journal of Cardiovascular Electrophysiology

DECEMBER 7, 2023

AS-APs can be successfully ablated from the right atrium (RA) or the aortic valve's noncoronary cusp (NCC). Methods and Results A 21-year-old female with supraventricular tachycardia (SVT) and pre-excitation on electrocardiogram (ECG) underwent electrophysiology study (EPS) confirming an AS-AP with anterograde and retrograde conduction.

Ablation 40

Ablation Electrophysiology Aortic valve Tachycardia 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Look at the aortic outflow tract. The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve. Aortic angiogram did not reveal aortic dissection. In fact, bedside ultrasound might even find severe aortic stenosis. What do you see?

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

Cardiometabolic Health Congress

AUGUST 30, 2024

Discover 2024’s Critical Advances in Cardiometabolic Care Here are some recent advances in cardiology: Aortic Disease : Moderate hypothermia during aortic arch surgery is effective, reducing the need for deep hypothermia.

Cardiac Rehabilitation 52

Cardiac Rehabilitation Heart Failure Quality of Life Aortic 52

Dr. Smith's ECG Blog

DECEMBER 13, 2019

The next morning the patient went for his routine echocardiogram, where the operator noticed a dilated aortic root at 5.47 cm with severe aortic insufficiency. The team was notified and they ordered a stat aortagram which showed type A aortic dissection from the aortic valve to the iliacs.

Pericarditis 52

Pericarditis Chest Pain Aortic Blog 52

EMS 12-Lead

JULY 24, 2023

Category 2 : An increase in myocardial oxygen demand due to tachycardia, elevated ventricular afterload (BP or aortic stenosis), or increased wall stretch (admittedly this latter is more complicated) or a decrease in oxygen supply due to hypotension, anemia, hypoxia, or a combination of all of the above. Aortic Stenosis f.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

JULY 22, 2012

Interpretation: There is sinus tachycardia, with right bundle branch block (RBBB). Blunt cardiac injury my result in : 1) Acute myocardial rupture with tamponade 2) Valve rupture (tricuspid, aortic, mitral) 3) Coronary thrombosis or dissection (and thus Acute MI) from direct coronary blunt injury 4) Dysrhythmias of all kinds.

Dysrhythmia 52

Dysrhythmia Biomarkers Echocardiogram Ultrasound 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. Systematic Assessment of the ECG in Figure-1: My Descriptive Analysis of ECG findings in Figure-1 is as follows: Sinus tachycardia at ~110/minute. A slightly prolonged QTc ( although this is difficult to assess given the tachycardia ). Left main?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

DECEMBER 14, 2016

The patient had no hypertension, no tachycardia, a normal hemoglobin, no drug use, no hypotension/shock, no murmur of aortic stenosis. We also looked at his aortic root by both parasternal and suprasternal views, and the aorta was normal.]

Chest Pain 52

Chest Pain STEMI Aortic Pulmonary 52

Dr. Smith's ECG Blog

OCTOBER 11, 2020

Other than tachycardia, Other than slight tachycardia, vitals were within normal limits (including oxygen saturation). Chest pain and Concordant ST Depression in a patient with aortic valve and previously normal angiogram Right Bundle Branch Block and ST Depression in V1-V3. Apparently he denied chest pain. Is that normal?

Chest Pain 52

Chest Pain STEMI Blog Tachycardia 52

Dr. Smith's ECG Blog

MAY 10, 2023

No signs for aortic dissection or pulmonary embolus. --"Results were discussed with the ordering physician. That said, against acute PE — is the inconstancy of this patient's symptoms — the lack of tachycardia — and the lack of any other ECG signs of acute RV strain. A CT Coronary angiogram was ordered. CAD-RADS category 1. --No

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

Sinus Tachycardia ( common in any trauma patient. ). Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). RBBB ( as by far the most common conduction defect — owing to the more vulnerable anatomic location of the RV ).

Arrhythmia 52

Arrhythmia Blog Chest Pain Cardiac Arrest 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

Here is another proven left main occlusion in a young woman who presented with sudden pulmonary edema, had this ECG recorded, then arrested and was resuscitated after 30 minutes of CPR: This has sinus tachycardia with RBBB and LAFB, and STE in V2-V6 as well as I, aVL This pattern could just as easily be seen in LAD occlusion. Knotts et al.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. If the patient has Abnormal Vital Signs (fever, hypotension, tachycardia, or tachypnea, or hypoxemia), then these are the primary issue to address, as there is ongoing pathology which must be identified. heart auscultation (aortic stenosis); c.

Arrhythmia 52

Arrhythmia Outcomes Chest Pain Risk Factors 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. However, there is also significant tachycardia , with heart rate of 116, and known hypoxia. Smith : "decompensation" of aortic stenosis might have initiated this entire cascade.

Tachycardia 74

Tachycardia Pulmonary Chest Pain Stenosis 74

Dr. Smith's ECG Blog

DECEMBER 16, 2024

Important: It is exceedingly rare for an anterior STEMI to be due to Aortic Dissection. Here it is: Type A Aortic Dissection Why was the troponin so elevated? The CT showed extensive type A aortic dissection which starts at the ostium of the RCA and extends all the way to the left iliac artery. This is easy to see.

Chest Pain 105

Chest Pain STEMI Aortic Ultrasound 105

Dr. S. Venkatesan MD

DECEMBER 23, 2024

Mind you, even an innocuous episode of fever, associated dyspnea, and tachycardia can elevate the mitral gradient and sound a false alarm. It needs a good knowledge of anatomy, physiology of inter & Intra valvular hemodynamics.It Depending solely on prosthetic valve gradients to diagnose obstruction is the biggest error we commit.

Bicuspid/Mitral 52

Bicuspid/Mitral Aortic valve Aortic Anatomy 52

Dr. Smith's ECG Blog

JANUARY 28, 2025

The QoH now correctly sees active OMI: A CT scan to rule out aortic dissection was performed (Smith: why???) Hans has not even been to medical school. One's training has NOTHING to do with one's OMI ECG interpretation skills. before transferring the patient to the cath facility. It was without evidence of dissection.

Chest Pain 105

Chest Pain STEMI Hospital Blood Pressure 105

Dr. S. Venkatesan MD

NOVEMBER 26, 2024

Same story for pressure half time, especially with tachycardia and little mitral regurgitation. There is something called low gradient severe MS (as in aortic stenosis). After all, we all know, with years of experience in echocardiography ,in a funnel-shaped degenerated mitral valve, we can get whatever MVO we desire to report !

Bicuspid/Mitral 40

Bicuspid/Mitral Stenosis Atrial Fibrillation Tachycardia 40