Remove Atrial Flutter Remove Dysrhythmia Remove Tachycardia
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A 50 year old man with sudden altered mental status and inferior STE. Would you give lytics? Yes, but not because of the ECG!

Dr. Smith's ECG Blog

There is the appearance of STE in inferior leads II, III, and aVF (with STD in aVR), but this is entirely due to flutter waves which are only seen in those leads. Also, the atrial flutter in this case is relatively slow like in many other cases we've shown. Tachycardia and ST Elevation. Atrial Flutter with Inferior STEMI?

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Back to basics: what is this rhythm? What are your options for treating this patient?

Dr. Smith's ECG Blog

We see a regular tachycardia with a narrow QRS complex and no evidence of OMI or subendocardial ischemia. The differential of a regular narrow QRS tachycardia is sinus tachycardia, SVT, and atrial flutter with regular conduction. There are no P waves preceding the QRS complexes, and no clear flutter waves.

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New Onset Heart Failure and Frequent Prolonged SVT. What is it? Management?

Dr. Smith's ECG Blog

Here was his ED ECG: There is sinus tachycardia (rate about 114) with nonspecific ST-T abnormalities. There is a large peaked P-wave in lead II (right atrial enlargement) There is left axis deviation consistent with left anterior fascicular block. See my quick review of atrial tachycardia below) The tachycardia spontaneously resolved.

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Young Man with a Heart Rate of 257. What is it and how to manage?

Dr. Smith's ECG Blog

Here is his 12-lead: There is a wide complex tachycardia with a rate of 257, with RBBB and LPFB (right axis deviation) morphology. Read about Fascicular VT here: Idiopathic Ventricular Tachycardias for the EM Physician Case Continued He was completely stable, so adenosine was administered. See Learning point 1 below. Arch Intern Med.

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Atrial fibrillation? Multifocal Atrial Tachycardia? Don't look at computer read until AFTER you interpret!

Dr. Smith's ECG Blog

The rhythm is indeed irregularly irregular, so atrial fibrillation must be considered. There are 5 other rhythms that are irregularly irregular , though atrial fibrillation is by far the most common: 1. Multifocal Atrial Tachycardia 2. Sinus with multifocal PACs 3. Sinus with multifocal PVCs 4.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

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. Most physicians will automatically be worried about these symptoms. The tracings were considered abnormal in the following cases: 1.