Dr. Smith's ECG Blog

MARCH 12, 2018

Notice I did not say "pulmonary embolism," because any form of severe acute right heart strain may produce this ECG. Differences of Pulmonary Embolism T-waves from Wellens' T-waves: 1. Despite heparin and supportive care, the patients mental status and blood pressure worsened. What is the answer? of patients without PE.

Chest Pain 40

Chest Pain Pulmonary Embolism Tachycardia 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Postoperatively, the patient was hypertensive to a systolic blood pressure of 220 mmHg that was controlled with a nicardipine infusion that was gradually weaned off once the patient’s vitals were stable while in the Neuro‐ICU. CT‐guided biopsy of the L3‐L4 disc was also obtained.

Aneurysm 40

Aneurysm Peripheral Arterial Disease Coronary Artery Disease ICU 40

Dr. Smith's ECG Blog

APRIL 26, 2017

Low LV filling pressures are due to several etiologies, most commonly due to volume depletion (dehydration or hemorrhage), but also due to other etiologies including, but not limited to: mitral stenosis, pulmonary hypertension (chronic, or due to pulmonary embolism), or poor RV performance.

Chest Pain 52

Chest Pain STEMI Ultrasound Pulmonary 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

EMS obtained the following vital signs: pulse 50, respiratory rate 16, blood pressure 96/49. [link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain.

Plaque 127

Plaque Angina Blog Stent 127

Dr. Smith's ECG Blog

MAY 10, 2023

Given that there was such a high blood pressure, it is possible that this is a type 2 MI (supply demand mismatch due to high oxygen demand when myocardium is pumping against such elevated blood pressure.) Her initial cTnI returned at 0.25 Wellens' syndrome will almost always develop elevated troponins.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Smith's ECG Blog

DECEMBER 14, 2016

The blood pressure was 110/60. The patient had been on a long drive, suggesting possible pulmonary embolism (this was unlikely given absence of tachyardia, hypoxia, or any other feature of PE), so we sent a d dimer. [We It was not relieved by anything. The pain was not positional, pleuritic, or reproducible.

Chest Pain 52

Chest Pain STEMI Aortic Myocardial Infarction 52

Dr. Smith's ECG Blog

AUGUST 14, 2023

The bedside echo showed a large RV (Does this mean there is a pulmonary embolism as the etiology?) When you suspect pulmonary embolism due to large RV on POCUS, always look for right axis deviation and a large R-wave in V1 because the large RV may be entirely due to chronic RVH, not acute PE. 2) Norepinephine to support Blood Pressure.

Chest Pain 52

Chest Pain Pulmonary Sickle Cell Disease Atrial Flutter 52

MIBHS

OCTOBER 31, 2024

High Blood Pressure (Hypertension) Persistent high blood pressure forces the heart to work harder to pump blood. Medications Medications are often the first line of treatment for cardiomegaly and can include: ACE inhibitors or ARBs , which help lower blood pressure and reduce the workload on the heart.

Blood Pressure 52

Blood Pressure Blood Clot Heart Valves Heart Rhythm 52

Frontiers in Cardiovascular Medicine

FEBRUARY 14, 2024

Background Pulmonary embolism is a condition of right cardiac dysfunction due to pulmonary circulation obstruction. Malignant tumor-induced pulmonary embolism, which has a poor therapeutic outcome and a significant impact on hemodynamics, is the cause of sudden death in patients with malignant tumors.

Embolism 64

Embolism Pulmonary Blood Pressure Hospital 64

Circulation

NOVEMBER 11, 2024

Unfortunately, on day 8 of hospitalization, he became bradycardic with no recordable blood pressures, and went into pulseless electrical activity soon after with an eventual demise.In this clinical case, we discussed sub-massive pulmonary embolism (PE) complicated by a right heart clot-in-transit presenting insidiously.

Embolism 40

Embolism Pulmonary Ultrasound ICU 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. Bi-phasic scan showed no dissection or pulmonary embolism. There was no premature cardiovascular diseases or sudden death in his family. He denies taking any medication. Peripheral pulses were all palpable.

STEMI 52

STEMI Chest Pain Myocardial Infarction Electrocardiogram 52

Cardiometabolic Health Congress

DECEMBER 7, 2023

Flexibility in using clinical risk scores and expanding beyond CHA2DS2-VASc for prediction of stroke and systemic embolism Currently, recommendations for anticoagulation are made based on yearly thromboembolic event risk using a validated clinical risk score, such as CHA2DS2-VASc.

Atrial Fibrillation 111

Atrial Fibrillation Risk Factors Ablation Stroke 111

Dr. Smith's ECG Blog

APRIL 8, 2015

Any ED systolic blood pressure less than 90 or greater than 180 mm Hg (+1) 4. The cost per test affecting diagnosis or management was highest for electroencephalography ($32,973), CT ($24,881), and cardiac enzymes ($22,397) and lowest for postural blood pressure ($17-$20). h/o heart disease (+1) 3.

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. There was no pulmonary embolism. His temperature was 32.8 What do you think?

Blood Pressure 111

Blood Pressure Cardiogenic Shock Ischemia Cardiac Arrest 111