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InterAtrial Block

EMS 12-Lead

David Didlake, EMT-P, RN, ACNP @DidlakeDW An early 80’s Female was transported to the ED with new-onset facial droop, slurred speech, and focal deficit. And since common things are common, the statistical probability favors Atrial Fibrillation (AFib) as the culprit. No previous medical history was reported. We do have the ECG.

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What do you think of this "Ventricular Bigeminy"?

Dr. Smith's ECG Blog

Written by Bobby Nicholson MD, with edits by Meyers A woman in her 50s with past medical history of heart failure, prior stroke, atrial fibrillation on Eliquis, lung cancer in remission, and CKD, presented to the emergency department for evaluation of cough and shortness of breath. Khouzam RN. What do you think? References: 1.

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Wide-complex tachycardia that didn’t follow the rules

Dr. Smith's ECG Blog

Although the emergency physician (along with an APRN and an RN) had not seen any alterations in the rhythm after adenosine was pushed, a paper recording of the episode was subsequently unearthed. The WCT is interrupted by a series of variable-morphology QRS complexes, with atrial flutter waves note in II, III, and aVF. A surprise clue!

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STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

There is atrial fibrillation. Comments: STEMI with hypokalemia, especially with a long QT, puts the patient at very high risk of Torsades or Ventricular fibrillation (see many references, with abstracts, below). This subsequent ECG was recorded after the K was up to 2.2 mEq/L: The STE is resolved. The QT is much shorter still.

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