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Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. The described rhythm was an irregular, wide complex rhythm. What is ELECTRICAL ALTERNANS?

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Unconscious + STEMI criteria: activate the cath lab?

Dr. Smith's ECG Blog

Prominent J waves and ventricular fibrillation caused by myocarditis and pericarditis after BNT162b2 mRNA COVID-19 vaccination. The final letter in the SLOWED mnemonic is " D " for "Dead" ( resulting from VT/VF or asystolic cardiac arrest ). This is the 2nd ECG from the February 8, 2022 post in Dr. Smith's ECG Blog ).

STEMI 52
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A woman in her 20s with syncope

Dr. Smith's ECG Blog

The second most common cause of medical cardiac tamponade is acute idiopathic pericarditis. Less common etiologies include uremia, bacterial or tubercular pericarditis, chronic idiopathic pericarditis, hemorrhage, and other causes such as autoimmune diseases, radiation, myxedema, etc. What is ELECTRICAL ALTERNANS?

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

He had multiple cardiac arrests with ROSC regained each time. Dyspnea, Chest pain, Tachypneic, Ill appearing: Bedside Cardiac Echo gives the Diagnosis 31 Year Old Male with RUQ Pain and a History of Pericarditis. Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism.

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Should we activate the cath lab? A Quiz on 5 Cases.

Dr. Smith's ECG Blog

Smith: This bizarre ECG looks like a post cardiac arrest ECG with probable acidosis or hyperkalemia in addition to OMI. Bottom Line: Tests other than cardiac cath may be all that are needed to establish the diagnosis — but, I'd want to see a patient with this ECG as soon as would be possible. What was the pH and K?

Ischemia 112
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Inferior ST Elevation: what is the Diagnosis?

Dr. Smith's ECG Blog

T-wave to ST ratio is greater than 4 in lead V6, making pericarditis unlikely (also there were no symptoms of pericarditis). Sudden cardiac arrest associated with early repolarization. There is ST elevation diffusely: 2 mm in V2, 3.5 mm in V3, 2.5 mm in V4, 1.5 mm in V5, and 1 mm in V6, 1.5 The computerized QTc is 386 ms.

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A woman in her 70s with chest pain

Dr. Smith's ECG Blog

Further Reading: [link] See these relevant cases: A man in his 50s with acute chest pain and diffuse ST depression "Pericarditis" strikes again Is it important to recognize LVH Pseudo-infarction patterns?