Blog Ischemia Tachycardia 
Ken Grauer, MD
JUNE 22, 2024
The ECG in Figure-1 — was obtained from a middle-aged woman with positional tachycardia and diaphoresis with change of position from suprine to sitting. My THOUGHTS on the ECG in Figure-1: The rhythm is sinus tachycardia at ~105/minute ( ie, The R-R interval is regular — and just under 3 large boxes in duration ).
Ken Grauer, MD
JUNE 27, 2024
IMPRESSION: Given the presence of a wide tachycardia — with 2 distinct QRS morphologies, and no sign of P waves — a presumed diagnosis of B i D irectional Ventricular Tachycardia has to be made. As discussed in ECG Blog #231 — Bidirectional VT is a special form of VT, in which there is beat-to-beat alternation of the QRS axis.
Ken Grauer, MD
MAY 20, 2023
Voltage for LVH is satisfied — at least by Peguero Criteria ( Sum of deepest S in any chest lead + S in V4 ≥23 mm in a woman — as discussed in ECG Blog #73 ). This point is particularly relevant regarding ECG #2 — because sinus tachycardia is seen on this earlier ECG. Smith's ECG Blog — Drs. NOTE: It's EASY to get fooled by LVH!
Ken Grauer, MD
MARCH 23, 2023
With experience, applying the P s, Q s, 3 R Approach ( See ECG Blog #185 ) — to formulate the above steps in our initial assessment of the rhythm in Figure-1 can ( should ) be completed in less than 30 seconds! These are reviewed in ECG Blog #343. What about the 1 2- L ead E CG ? The QTc is not overly prolonged.
Dr. Smith's ECG Blog
JANUARY 9, 2024
She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. Are you confident there is no ischemia? Answer : The ECG above shows a regular wide complex tachycardia. Said differently, the ECG shows a rather slow ventricular tachycardia with a 2:1 VA conduction. Is this: 1.
Dr. Smith's ECG Blog
JANUARY 2, 2025
It should be kept in mind that on occasions, beta-one agonist can result in increased ventricular ectopy e.g., in severe myocardial ischemia (by increasing myocardial demand), or sometimes with congenital long-QT syndrome. Even with tachycardia and a paced QRS duration of ~0.16
Ken Grauer, MD
SEPTEMBER 21, 2024
MY Interpretation of Today's Initial ECG: I've labeled key findings in Figure-2 for today's initial ECG: The rhythm is sinus tachycardia at ~105/minute. The sinus tachycardia is a definite concern that something acute may be ongoing. Does the patient's age infuence your interpretation? Figure-1: The initial ECG in today's case. (
Expert insights. Personalized for you.
171 
Let's personalize your content