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ECG Blog #450 — A "Healthy" 30yo with Dizziness

Ken Grauer, MD

To improve visualization — I've digitized the original ECG using PMcardio ) MY Thoughts on the ECG in Figure-1: This is a challenging tracing to interpret — because there is marked bradycardia with an irregular rhythm and a change in QRS morphology. In my ECG Blog #61 — I addressed the issue of vagotonic block. second in duration ).

Blog 103
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Serial ECGs for chest pain: at what point would you activate the cath lab?

Dr. Smith's ECG Blog

Written by Jesse McLaren A healthy 75 year old developed 7/10 chest pain associated with diaphoresis and nausea, which began on exertion but persisted. Below is the first ECG recorded by paramedics after 2 hours of chest pain, interpreted by the machine as “possible inferior ischemia”. What do you think?

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A 50-something with chest pain.

Dr. Smith's ECG Blog

This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.

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46 year old with chest pain develops a wide complex rhythm -- see many examples

Dr. Smith's ECG Blog

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. The patient continued having chest pain. This has been discussed many times before on this blog. Do not treat AIVR.

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ECG Blog #396 — Why the Flat Line?

Ken Grauer, MD

KEY Point: Although true that patients with longstanding, severe pulmonary disease may manifest a QRST complex in standard lead I with marked overall reduction in QRST amplitude ( See ECG Blog #65 — regarding Schamroth’s Sign ) — you should never normally see a completely flat line in any of the standard limb leads.

Blog 166
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A 50-something with chest pain. Is there OMI? And what is the rhythm?

Dr. Smith's ECG Blog

Written by Willy Frick A man in his 50s with history of hypertension, hyperlipidemia, and a 30 pack-year smoking history presented to the ER with 1 hour of acute onset, severe chest pain and diaphoresis. His ECG is shown: What do you think? That is, until the 7th R wave which comes a little bit sooner than expected. What do you think?

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Texted from a former EM resident: 70 yo with syncope and hypotension, but no chest pain. Make their eyes roll!

Dr. Smith's ECG Blog

No Chest Pain, but somnolent. The fact that this is syncope makes give it a far lower pretest probability than chest pain, but it was really more than syncope, as the patient actually underwent CPR and had hypotension on arrival of EMS. Here is the ED ECG (a photo of the paper printout) What do you think?