EMS 12-Lead

SEPTEMBER 8, 2024

Bradycardia with “borderline hypotension” as described by the paramedics (BP 104/40) with 3-lead ECG as seen in Figure 1 were found. Blood pressures after pacing initiation improve (125/80, 130/66, 150/113) and improvement in ETCO2 (30-32mmHg). Rhonchi are auscultated bilaterally.

Blood Pressure 92

Blood Pressure Bradycardia Hospital Electrophysiology 92

Conquering CHD

JULY 11, 2023

Blood Pressure Many medications used to treat congenital heart disease can affect blood pressure levels. It’s crucial to monitor your blood pressure regularly and report any significant changes to your healthcare provider so they can adjust the dosage of the medication accordingly.

Congenital Heart Disease 52

Congenital Heart Disease Congenital Heart Disease Blood Clot 52

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

Acute MI per se usually does not depress cardiac function and blood pressure enough to cause syncope ( Mostafa et al — J Com Hosp Intern Med Perspect 13(4):9-12, 2023 - ). Other cardiac-related causes for syncope associated with acute MI may include malignant ventricular arrhythmias and bradyarrhythmias including AV block.

Chest Pain 114

Chest Pain Aneurysm Stents Stent 114

Dr. Smith's ECG Blog

JANUARY 13, 2024

That evening when he arrived home, he had an unexpected fall while getting out of the car, blood pressure was reported to be 88/53. A week after discharge the patient fell again, blood pressure was reported as 73/62. The case continues. The patient was discharged the morning after the procedure.

Pacemaker 110

Pacemaker Bicuspid/Mitral Blood Pressure Bradycardia 110

All About Cardiovascular System and Disorders

MAY 2, 2024

Systemic vascular resistance falls, but slight to moderate increase in blood pressure can occur due to the increased cardiac output. But there is significant rise in blood pressure leading to pressure overload to the left ventricle.

Exercise 40

Exercise Cardiomyopathy Blood Pressure Physiology 40

Dr. Smith's ECG Blog

JANUARY 5, 2024

The ECG shows sinus bradycardia but is otherwise normal. Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." The documentation does not describe any additional details of the history. The following ECG was obtained. ECG 1 What do you think?

Angina 120

Angina Plaque Document Stents 120

Dr. Smith's ECG Blog

JUNE 19, 2024

Three months prior to this presentation, he received a pacemaker for severe bradycardia and syncope due to sinus node dysfunction. Another blood pressure was checked. He was severely hypotensive, with a systolic pressure in the 50s. The ED provider ordered a coronary CT scan to assess the patient for CAD.

Chest Pain 60

Chest Pain Pericarditis Pacemaker STEMI 60

Dr. Smith's ECG Blog

MAY 30, 2023

BP was 108 systolic (if a cuff pressure can be trusted) but appeared to be maintaining BP only by very high systemic vascular resistance. Here is his ED ECG: There is bradycardia with a junctional escape. Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia. What is the atrial activity?

Chest Pain 97

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 97

DAIC

JANUARY 19, 2024

AVIM therapy is an investigational patented bioelectronic therapy, administered using a standard dual-chamber pacemaker, designed to immediately, substantially and persistently reduce blood pressure. mmHg in office systolic blood pressure (oSBP) at six months when compared to control patients. Kowal, M.D., vs. 14.3%).

Pacemaker 105

Pacemaker Hypertension Blood Pressure Kidney Disease 105

Dr. Smith's ECG Blog

OCTOBER 7, 2019

Both of these features make inferior + RV MI by far the most likely ( Pseudoanteroseptal MI is another name for this ) There is also sinus bradycardia and t he patient is in shock with hypotension. A narrow complex bradycardia without any P-waves is also likely to respond to atropine, as it may be a junctional rhythm.

Bradycardia 40

Bradycardia Cardiogenic Shock STEMI Ischemia 40

EMS 12-Lead

MAY 15, 2024

Crew notifies the received ED of an incoming post-arrest patient and notes a sinus bradycardia on their monitor, as seen in Figure 2. Figure 2 : This rhythm shows a sinus bradycardia at a rate between 30 and 40bpm. The crew immediately initiated TCP at a rate of 70bpm and slowly increased the current, as shown in Figure 3.

Atrial Fibrillation 132

Atrial Fibrillation Bradycardia Pacemaker Cardiac Arrest 132

Dr. Smith's ECG Blog

OCTOBER 20, 2024

On arrival in the emergency department, invasive blood pressure was 35/15mmHg and the patient was in profound cardiogenic shock with severe confusion secondary to brain hypoperfusion. The arterial blood gas showed a lactic acidosis with a lactate level of 17mmol/L. PUSH THE LYTICS ! The below ECG (ECG #4) was recorded.

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Dr. Smith's ECG Blog

JULY 21, 2024

Immediately after contrast injection into the LMCA, the patient had circulatory collapse, with a precipitous drop in blood pressure. An Impella device was placed to maintain cardiac output and perfusion pressures. There was no evidence bradycardia leading up to the runs of PMVT ( as tends to occur with Torsades ).

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Heart BMJ

DECEMBER 15, 2023

Reflex syncope is defined as a transient loss of consciousness due to a neurally mediated reflex causing sudden-onset vasodilation and bradycardia, leading to a steep decrease in blood pressure and cerebral hypoperfusion.

Blood Pressure 40

Blood Pressure Bradycardia Pacemaker Arrhythmia 40

Dr. Smith's ECG Blog

DECEMBER 22, 2022

Blood pressure: 130/80 mmHg, heart rate: 45/min, respiratory rate: 18/min, SaO2: %98, body temperature: normal. His first electrocardiogram ( ECG) is given below: --Sinus bradycardia. On his physical examination, cardiac and pulmonary auscultation was completely normal. Peripheral pulses were all palpable.

STEMI 52

STEMI Chest Pain Myocardial Infarction Electrocardiogram 52

Dr. Smith's ECG Blog

MAY 5, 2022

On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s. Hyperkalemia causes peaked T waves and the "killer B's of hyperkalemia", including bradycardia, broad QRS complexes, blocks of the AV node and bundle branches, Brugada morphology, and otherwise bizarre morphology including sine wave.

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 52

Dr. Smith's ECG Blog

JULY 24, 2018

Compartment pressures in the right calf were all 40-50 mmHg. At that time his diastolic blood pressure was also hovering between 45 and 55 mmHg. Hyperkalemia findings include the classic peaked T-waves, as well as the deadly B's of hyperkalemia: Broad (wide QRS), Brady (bradycardia), Blocks (AV blocks), and Bizarre.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Tachycardia ICU 52

Dr. Smith's ECG Blog

APRIL 6, 2018

Because hyperkalemia kills by either VT or VF arrest, or by bradycardia with PEA arrest, this should be assumed to be VT until proven otherwise. The arterial line blood pressure immediately jumped from 80/40 with blunted monomorphic waveform to 140s/80s with bounding, normal-appearing waveform.

Cardiac Arrest 52

Cardiac Arrest Tachycardia Defibrillator ICU 52

Dr. Smith's ECG Blog

APRIL 8, 2015

PVCs N ot generally considered abnormal ECG findings: Isolated PAC, First Degree AV Block, Sinus bradycardia at a rate of 35-45, and Nonspecific ST-T abnormalities (even if different from a previous ECG). Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful.

Arrhythmia 52

Arrhythmia Outcomes Risk Factors Chest Pain 52

Dr. Smith's ECG Blog

APRIL 6, 2025

They were unable to obtain a blood pressure. His heart rate was in the low 20s and we were also unable to obtain a blood pressure. He was given 50 mcg epinephrine with good response in both heart rate and blood pressure. His rhythm on telemetry seemed to be sinus bradycardia vs junctional rhythm.

Blood Pressure 111

Blood Pressure Cardiogenic Shock Ischemia Cardiac Arrest 111

Dr. Smith's ECG Blog

MAY 23, 2022

Patient 2 : 55 year old with 5 hours of chest pain radiating to the shoulder, with nausea and shortness of breath ECG: sinus bradycardia, normal conduction, normal axis, normal R wave progression, no hypertrophy. Smith : The fact that the ECG did not evolve is further proof that this was the baseline ECG.

Chest Pain 52

Chest Pain Pericarditis STEMI Arrhythmia 52

Dr. Smith's ECG Blog

FEBRUARY 18, 2025

His first recorded blood pressure was 88/53 mm Hg. Forty five minutes later, his blood pressure increased to 157/125 mm Hg, but his heart rate was now in the 30s. The next recorded blood pressure was 211/175 mm Hg, and in response the patient was started on continuous nitroglycerin infusion.

Blood Pressure 63

Blood Pressure Blog Cardiac Arrest Bradycardia 63