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Chest pain with anterior ST depression: look what happens if you use posterior leads.

Dr. Smith's ECG Blog

Written by Jesse McLaren A 65 year old with a history of atrial flutter, CABG and end-stage renal disease on dialysis presented with 3 days of fluctuating chest pain, which was ongoing at triage. So a patient with high pretest probability (prior CABG with new chest pain), had new ECG changes showing posterior OMI.

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Chest pain and rapid pacing followed by an unexplained wide complex tachycardia. Time for cardioversion?

Dr. Smith's ECG Blog

Written by Willy Frick with edits by Ken Grauer An older man with a history of non-ischemic HFrEF s/p CRT and mild coronary artery disease presented with chest pain. He said he had had three episodes of chest pain that day while urinating. ECG 1 What do you think? There is a lot going on in this ECG.

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What does the ECG show in this patient with chest pain, hypotension, dyspnea, and hypoxemia?

Dr. Smith's ECG Blog

Written by Pendell Meyers, with some edits by Smith A man in his 40s with many comorbidities presented to the ED with chest pain, hypotension, dyspnea, and hypoxemia. The rhythm is 2:1 atrial flutter. An 80-something woman who presented with chest pain and dyspnea. Here is his triage ECG: What do you think?

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A Middle-Aged Man with Chest pain, Hypotension and Tachycardia

Dr. Smith's ECG Blog

In the evening, a middle-aged man complained of chest pain at the nursing home. His chest pain was vague. He mentioned "cancer" and "chest". Leads II and aVF appear to have flutter waves. I diagnosed atrial flutter with 2:1 conduction. He was awake, with a pulse of 130 and BP of 50/30.

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A man in his 70s with acute chest pain and paced rhythm.

Dr. Smith's ECG Blog

Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. LAFB, atrial flutter, anterolateral STEMI(+) OMI. Triage ECG: What do you think? This is diagnostic of proximal LAD occlusion.

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Very Fast Very Wide Complex Tachycardia

Dr. Smith's ECG Blog

A male in his 60's called 911 for dizziness and chest pain, onset with exertion. If it is slow Atrial flutter with 1:1 conduction, it should slow the conduction and reveal the flutter waves. Rate 120, flutter rate 240. How do I know (or think I know) it was atrial flutter with aberrancy?

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Syncope while on a treadmill

Dr. Smith's ECG Blog

To me, it was clearly atrial flutter with 1:1 conduction. The rate of 280 is just right for atrial flutter. The waves look like atrial flutter waves, NOT like a wide ventricular complex. Recently diagnosed with intermittent paroxysmal atrial fibrillation but no EKGs available to confirm.