HeartRhythm

FEBRUARY 28, 2024

His examination was normal (with a blood pressure of 120/70mmHg) except for tachycardia (Figure 1). A 64-year-old man presented with epigastric discomfort and palpitations after a festive meal. He reported taking no medications.

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Tachycardia Blood Pressure 40

Dr. Smith's ECG Blog

OCTOBER 26, 2010

He presented to the Emergency Department with a blood pressure of 111/66 and a pulse of 117. He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. He had this ECG recorded.

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STEMI Cardiogenic Shock Tachycardia Aneurysm 52

AMS Cardiology

NOVEMBER 21, 2024

This is because stress causes an increase in cortisol – the primary stress hormone – leading to increases in blood pressure , cholesterol, blood sugar and heart rate. Cold temperatures alone impact the body by causing the coronary arteries to constrict, blood pressure to rise and the heart to work harder.

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Heart Attack Heart attacks Heart Failure Blood Pressure 52

Dr. Smith's ECG Blog

MARCH 11, 2012

Blood pressure was 180/80. Here was his initial ECG: Regular Wide Complex Tachycardia. Differential of Wide Complex Tachycardia (check out this post) -- Sinus with aberrancy -- Aberrancy can be due to toxins (wide complex from the many drugs which have sodium channel blocking effects and prolong the QRS) --SVT with aberrancy.

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Tachycardia Chest Pain Pulmonary Blood Pressure 52

Dr. Smith's ECG Blog

AUGUST 13, 2020

His previous echo one month prior shows the same thing: “consistent with old infarct in LAD vascular territory, with EF 45%” "I think there is something else causing his tachycardia which is exaggerating his EKG findings and mimicking an acute myocardial infarction." The patient spontaneously converted back to sinus tachycardia.

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Tachycardia AFIB Cardiogenic Shock Myocardial Infarction 52

Dr. Smith's ECG Blog

OCTOBER 23, 2023

An Initial ECG was performed: Initial ECG: Sinus tachycardia with prolonged QT interval (QTc of 534 ms by Bazett). She was admitted to the ICU where subsequent ECGs were performed: ECG at 12 hours QTc prolongation, resolution of T wave alternans ECG at 24 hours Sinus tachycardia with normalized QTc interval. No ischemic ST changes.

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Dr. Smith's ECG Blog

FEBRUARY 8, 2015

They had already cardioverted at 120 J, then 200 J, which resulted in the following: Ventricular Tachycardia They then cardioverted at 200 J which r esulted in the same narrow complex rhythm shown above, at 185 beats per minute. This would treat both SVT or sinus tachycardia. I suggested esmolol if the heart rate did not improve.

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Tachycardia Chest Pain Pharmacology Myocardial Infarction 52

All About Cardiovascular System and Disorders

MARCH 23, 2024

Sometimes, head up tilt test, also known in short as HUTT, is also done for the evaluation of postural orthostatic tachycardia syndrome, POTS, a condition in which there is tachycardia on standing up, without a fall in blood pressure. If syncope does not occur with 70 degrees tilt, it can be done at 80 degrees tilt.

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Blood Pressure Bradycardia POTS Tachycardia 52

Ken Grauer, MD

AUGUST 16, 2024

MY Thoughts on this CASE: Not being there — I am unaware of physical exam parameters ( blood pressure, respiratory rate; oxygen saturation; heart and lung auscultation, etc. ). 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.

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MIBHS

JANUARY 31, 2025

Early detection of conditions like AFib, bradycardia, or tachycardia allows patients to address issues before they become critical. By understanding patterns in heart rate, blood pressure, and oxygen levels, surgeons can tailor procedures to the individuals needs.

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Heart Rhythm Technology AFIB Exercise 52

Dr. Sanjay Gupta

JANUARY 25, 2022

Dr Sanjay Gupta, a consultant cardiologist at York Hospital, is an expert in POTS, or postural tachycardia syndrome. The condition can leave sufferers debilitated, constantly exhausted, and sometimes unable even to walk.

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POTS Hospital Chest Pain Blood Pressure 52

Frontiers in Cardiovascular Medicine

FEBRUARY 5, 2024

Although sinus tachycardia is the most commonly encountered rhythmic disturbance, subsequent reports have highlighted other findings. She presented with presyncope and an initial blood pressure of 77/63 mmHg. Echocardiography confirmed signs of right ventricular dysfunction.

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Embolism Pulmonary Blood Pressure Electrocardiogram 49

Heart BMJ

MARCH 22, 2024

On examination, the pulse rate was around 190 beats/min with a systolic blood pressure of 80 mm Hg. ECG at presentation was suggestive of ventricular tachycardia (VT) ( figure 1 A ). Resuscitation with urgent cardioversion in view of haemodynamic instability with wide complex tachycardia was done.

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Dysrhythmia Blood Pressure Tachycardia Laboratory 40

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.

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Congenital Heart Disease Congenital Heart Disease Blood Clot 52

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.

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Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Conquering CHD

JUNE 20, 2023

Blocking this enzyme helps relax blood vessels so there is a wider opening for better blood flow. This will lower blood pressure, making it easier for the heart to pump. POTENTIAL SIDE EFFECTS: Potential adverse reactions include coughing, dizziness, kidney problems, and low blood pressure.

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Congenital Heart Disease Congenital Heart Disease ACE Inhibitor 52

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. You can see Left Main and Proximal LAD obstruction, but with some flow, which is saving this patient's life.

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

APRIL 6, 2018

There is a regular, wide complex, (mostly) monomorphic tachycardia. The differential of wide, regular, monomorphic tachycardia is: VT or SVT with aberrancy, all +/- hyperkalemia (see diagrams below). Really wide tachycardia = VT or SVT with conduction abnormality + hyperkalemia, until proven otherwise.

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Cardiac Arrest Tachycardia Defibrillator ICU 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

Blood pressure was normal (109/83). Here is his 12-lead: There is a wide complex tachycardia with a rate of 257, with RBBB and LPFB (right axis deviation) morphology. Read about Fascicular VT here: Idiopathic Ventricular Tachycardias for the EM Physician Case Continued He was completely stable, so adenosine was administered.

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Tachycardia Heart Disease Dysrhythmia Ablation 52

EMS 12-Lead

APRIL 28, 2022

Initial vital signs include: NIBP 99/58 HR 150-160 (trend) RR 10 (spontaneous, but shallow) SpO2 86 (RA) BBS CTA The initial rhythm strip is attached: Figure 1 There is a wide complex tachycardia of varying morphology, amplitude, and R-R cycle length. Chapter 10: Recurrent Ventricular Tachycardia (pg. 2] Viskin, S., 3] Murphy, M.

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Tachycardia AFIB Arrhythmia Coronary Artery Bypass Graft 52

Dr. Smith's ECG Blog

APRIL 12, 2013

Blood pressure was 215/124 and HR 115 (on metoprolol). Here is his ED ECG: There is sinus tachycardia. The amount of ST elevation and depression is slightly less than on the ECG above, but there is also no tachycardia, which tends to exaggerate ST deviation.

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STEMI Pulmonary Stents Stent 52

Dr. Smith's ECG Blog

DECEMBER 7, 2023

Most Type 2 OMI are due to supply-demand O2 mismatch that do NOT involve a dynamic change in the coronanry artery: 1) decreased O2 supply from (a) low blood pressure, especially in the presence of fixed coronary stenosis (b) hypoxia, (c) anemia (d) hemoglobinopathies such as CO poisoning or (e) oxidative phosphorylation problems (CN or HS) [(d) and (..)

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SCAD Ischemia Coronary Artery Disease Cardiomyopathy 124

Dr. Smith's ECG Blog

MARCH 12, 2018

The findings include sinus tachycardia, characteristic QRS morphology most diagnostic in V3 with a small R wave followed by a very large S wave with a convex upward ST segment morphology, ST segment strain morphology in the inferior and anterior leads leading to deep symmetric T-wave inversion. and tachycardia, 1.8. incomplete RBBB 1.7

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Chest Pain Pulmonary Embolism Tachycardia 40

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

The ECG shows sinus tachycardia, a narrow, low voltage QRS with alternating amplitudes, no peaked T waves, no QT prolongation, and some minimal ST elevation in II, III, and aVF (without significant reciprocal STD or T wave inversion in aVL). It is difficult to tell if there is collapse during diastole due to the patient’s tachycardia.

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Tachycardia Pericarditis Ultrasound Blood Pressure 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

The initial blood pressure was 80/palp with a heart rate of 104, respirations 20, oxygen saturations of 94% and a finger stick blood glucose of 268. In addition, the patient received 750 mL of fluid resuscitation with transient improvement of blood pressure.

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Ischemia Cardiogenic Shock Aortic Stenosis 40

Dr. Smith's ECG Blog

DECEMBER 14, 2016

The blood pressure was 110/60. The patient had no hypertension, no tachycardia, a normal hemoglobin, no drug use, no hypotension/shock, no murmur of aortic stenosis. It was not relieved by anything. The pain was not positional, pleuritic, or reproducible. He had no previous medical history. If it is MI, is it type 1 or type 2?

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Chest Pain STEMI Aortic Pulmonary 52

Dr. Smith's ECG Blog

JULY 24, 2018

Prior ECG on file: Sinus tachycardia, imperfect baseline, otherwise unremarkable. Sinus tachycardia with unequivocal evidence of hyperkalemia, including widened QRS with "pulled apart" morphology (widened QRS) compared to baseline, as well as clearly peaked T-waves. Compartment pressures in the right calf were all 40-50 mmHg.

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Cardiac Arrest Tachycardia Chest Pain ICU 52

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

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Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Smith's ECG Blog

AUGUST 14, 2023

2) Norepinephine to support Blood Pressure. The RV is normally a low pressure chamber, and perfusion happens in both systole and diastole (unlike the LV, which only perfuses in diastole when the pump is not squeezing). The rhythm in ECG #1 is not Sinus Tachycardia — because there is no upright P wave in lead II.

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Chest Pain Pulmonary Sickle Cell Disease Atrial Flutter 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. After initiating treatment for hyperkalemia, repeat ECG showed resolution of Brugada pattern: The ECG shows sinus tachycardia. A Very Wide Complex Tachycardia. Fluid resuscitation was initiated. What is the Rhythm? Use Lewis Leads!!

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Chest Pain Bradycardia Cardiac Arrest STEMI 52

Dr. Smith's ECG Blog

JULY 12, 2020

The cardiac monitor showed sinus rhythm but the automatic blood pressure cuff was not reading. We arrived in the resuscitation bay and recorded a heart rate of 115 bpm and blood pressure of 50/30 mm Hg. Why would she have such varying blood pressure? She was discharged home in good condition.

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Pericarditis Hospital Ultrasound Blood Pressure 40

EMS 12-Lead

APRIL 21, 2022

pre-existing, stable atherosclerosis) amidst any state of global duress – to include hypertension, hypoxia, tachycardia, hypotension, sepsis, and GI bleed, for example. Although the blood pressure resolved, his pain, however, did not. There may even be significant overlap between these factors.

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Ischemia Myocardial Infarction Blog Coronary Angiogram 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2023

He is placed on heparin drip, he will have IV beta-blocker and oral beta blocker for heart rate control and blood pressure management. There is sinus tachycardia at 100-105/minute. "Discussed with the on-call cardiologist, there are currently no beds available at other facilities within the system, so he will be kept here.

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Dr. Smith's ECG Blog

OCTOBER 7, 2019

Although the shock is no doubt partly a result of poor pump function, with low stroke volume, especially of the RV, it should be compensated for by tachycardia. This is particularly true of RV MI: LV coronary perfusion is dependent on diastolic pressure because the myocardial pressure is too high for perfusion during systole.

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Bradycardia STEMI Cardiogenic Shock Ischemia 40

Wellnest

JULY 19, 2023

However, recent studies have observed that people below 40 are also experiencing heart attacks due to high blood pressure, cholesterol, diabetes, smoking, obesity, a sedentary lifestyle, and social and mental stress. This indicates that restoring normal blood circulation as quickly as possible will result in less damage.

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Heart Attack Heart attacks Blood Pressure Myocardial Infarction 52

European Journal of Heart Failure

NOVEMBER 14, 2023

Significant LGE at CMR; LVEF <50%; abnormal blood pressure response during exercise test; LV apical aneurysm; high-risk genotype. Syncope, LGE on CMR, inducible sustained VT at PES, pathogenic mutations in LMNA, PLN, FLNC, and RBM20.

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Sudden Cardiac Death Cardiomyopathy Risk Factors Heart Failure 40

Dr. Smith's ECG Blog

APRIL 8, 2015

If the patient has Abnormal Vital Signs (fever, hypotension, tachycardia, or tachypnea, or hypoxemia), then these are the primary issue to address, as there is ongoing pathology which must be identified. Any ED systolic blood pressure less than 90 or greater than 180 mm Hg (+1) 4. h/o heart disease (+1) 3.

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