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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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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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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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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 124
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Cardiologist declines taking patient to the cath lab. Patient dies.

Dr. Smith's ECG Blog

As always, takotsubo cardiomyopathy and focal pericarditis can mimic OMI, but takotsubo almost never mimics posterior MI, and both are diagnoses of exclusion after a negative cath. About two hours after admission, he suffered a cardiac arrest (whether it was VF/VT or PEA is not available) and expired. Were they right?

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Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

Dr. Smith's ECG Blog

ECG of pneumopericardium and probable myocardial contusion shows typical pericarditis Male in 30's, 2 days after Motor Vehicle Collsion, complains of Chest Pain and Dyspnea Head On Motor Vehicle Collision. What are the ECG Findings of Cardiac Contusion? ST depression. Myocardial Contusion?

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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?