Blog Chest Pain Tachycardia 
Ken Grauer, MD
SEPTEMBER 21, 2024
For example, considering whatever symptoms that the patient may have had ( ie, chest pain, palpitations, shortness of breath, etc. ) — what this might mean in view of the ECG we are looking at. The sinus tachycardia is a definite concern that something acute may be ongoing. Does the patient's age infuence your interpretation?
Ken Grauer, MD
MARCH 27, 2024
No chest pain. This leaves us with the usual differential diagnosis for this rhythm presentation ( as per ECG Blog #361 ) ==> We need to consider i ) VT until proven otherwise: ii ) SVT with either preexisting BBB or aberrant conduction; — or , iii ) Something else ( ie, WPW, hyperkalemia, some other toxicity, etc. ).
Ken Grauer, MD
MARCH 1, 2024
No clear history for recent chest pain — but the patient "has not been well" for the previous week. C linical I MPRESSION: I would interpret ECG #1 as suggestive of near ventricular standstill — with underlying atrial tachycardia, extended pauses, and no reliable ventricular escape focus. This is often a pre-lethal rhythm.
Ken Grauer, MD
JUNE 14, 2024
The rhythm is regular — at a rate just over 100/minute = sinus tachycardia ( ie, the R-R interval is just under 3 large boxes in duration ). Continuing with assessment of ECG #1 in Figure-2: The rhythm is sinus tachycardia at ~110/minute. NOTE: Abnormal baseline deflections in Figure-2 are maximal i n leads I , II and aVR.
Ken Grauer, MD
AUGUST 29, 2024
One reason why LBBB conduction in a patient with marked LVH may not evolve to a predominant ( if not all positive ) R wave by lead V6 — is that leftward and posterior forces of marked LVH with LBBB may delay transition to predominant positivity in the chest leads until more posteriorly oriented chest leads, such as V7 or V8.
Ken Grauer, MD
AUGUST 16, 2024
I see the following: There is sinus tachycardia ( upright P wave with fixed PR interval in lead II ) — at the rapid rate of ~130/minute. See ECG Blog #435 — ECG Blog #313 — as well as My Comment at the bottom of the page in the June 17, 2024 post in Dr. Smith's ECG Blog ). Sinus tachycardia has resolved.
Dr. Smith's ECG Blog
SEPTEMBER 29, 2023
Sent by anonymous, written by Pendell Meyers, reviewed by Smith and Grauer A man in his 40s presented to the ED with HTN, DM, and smoking history for evaluation of acute chest pain. He was eating lunch when he had sudden onset chest pressure, 9/10, radiating to his back, with sweating and numbness in both hands.
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