Dr. Smith's ECG Blog

APRIL 29, 2020

A 60-something woman presented after a witnessed cardiac arrest. This is commonly found after epinephrine for cardiac arrest, but could have been pre-existing and a possible contributing factor to cardiac arrest. Final Diagnosis: Cardiac Arrest due to Torsades from long QT of unknown etiology.

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Dr. Smith's ECG Blog

JULY 24, 2018

One hour later (labs not yet returned), here is the ECG recorded just after the team noticed a sudden wide complex with precipitous decompensation, just before cardiac arrest: Bizarre, Brady, and Broad (wide QRS). Unfortunately, this was not recognized at this time. I believe it was this point when hyperkalemia was first suspected.

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EMS 12-Lead

MAY 15, 2024

Patient had an unwitnessed cardiac arrest without bystander CPR performed. 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.

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Atrial Fibrillation Bradycardia Pacemaker Cardiac Arrest 132

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

Altered Mental Status, Bradycardia == MY Comment , by K EN G RAUER, MD ( 2/2 /2024 ): == Dr. Meyers began today’s case with the clinical challenge of asking you to identify the underlying cause of ECG #2. -- Read this ECG -- Osborn Waves and Hypothermia (this is the "Figure" above) What does LBBB look like in severe hypothermia?

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EMS 12-Lead

MARCH 30, 2024

This false electrical capture may have made cardiac arrest recognition difficult, and the re-arrest may have gone unrecognized for an unknown amount of time. Learning points: TCP is primarily recommended for bradycardia that does not respond to atropine, or other agents. Current 85mA. On ED arrival ROSC is achieved.

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Dr. Smith's ECG Blog

JUNE 5, 2024

Uncontrolled coronary spasm may be associated with serious arrhythmias , including cardiac arrest ( Looi et al — Postgrad Med, 2012 ; Tan et al — Eur Heart J Case Rep, 2018 ; Chevalier et al — JACC, 1998 ; Rodriguez-Manero — EP Europace, 2018 ). Initial high sensitivity troponin I returned at 6ng/L (normal 0.20

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Chest Pain Blog Cardiac Arrest Cardiomyopathy 106

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

Osborn waves have been reported with hypercalcemia, brain injury, subarachnoid hemorrhage, Brugada syndrome, cardiac arrest from VFib — and — severe, acute ischemia resulting in acute MI ( See My Comment in the November 22, 2019 post on Dr. Smith’s Blog ). Rituparna et al — as well as Chauhan and Brahma ( Int.

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Cardiac Arrest Bradycardia Chest Pain Ischemia 52

Wellnest

DECEMBER 21, 2022

A fast heartbeat is called tachycardia, while a slow heartbeat is called bradycardia in medical terms. Cardiac arrest Cardiac arrest is a medical emergency in which the heart stops pumping blood to the body. Electrocardiogram, echocardiogram, and some other tests are done for patients with cardiac arrest.

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Wellnest

JUNE 19, 2023

Similarly, you may use our , app to adjust the paper speed along with amplification to read the slightest changes, especially for conditions like tachycardia and bradycardia. AI recognizing cardiac arrests in emergency calls. AI recognizing cardiac arrests in emergency calls.

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Technology Cardiac Arrest Innovation Coronary Artery Disease 52

Dr. Smith's ECG Blog

JULY 21, 2024

There was no evidence bradycardia leading up to the runs of PMVT ( as tends to occur with Torsades ). If there had been — a temporary atrial pacemaker could have been considered as a way of increasing the heart rate to suppress a bradycardia-dependent arrhythmia ("overdrive pacing").

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Dr. Smith's ECG Blog

MAY 5, 2022

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. Steve, what do you think of this ECG in this Cardiac Arrest Patient?" With a twist.

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Dr. Smith's ECG Blog

OCTOBER 20, 2024

This patient is actively dying from a left main coronary artery OMI and cardiac arrest from VT/VF or PEA is imminent! Complete LMCA occlusion is associated with clinical shock and/or cardiac arrest. The arterial blood gas showed a lactic acidosis with a lactate level of 17mmol/L.

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Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 125

Dr. Smith's ECG Blog

OCTOBER 25, 2023

Polymorphic Ventricular Tachycardia Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management Cardiac Arrest. A New Seizure in a Healthy 20-something More cases of long QT not measured correctly by computer (these are all fascinating ECGs/cases): Bupropion Overdose Followed by Cardiac Arrest and, Later, ST Elevation.

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Dr. Smith's ECG Blog

JANUARY 21, 2023

This ECG shows a sinus bradycardia with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, normal R-wave progression, normal voltages. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. There is marked sinus bradycardia. What do you think? As per Drs.

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STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Dr. Smith's ECG Blog

FEBRUARY 27, 2023

For example — marked bradycardia with unusual forms of advanced AV block — or marked bradycardia without evident P waves — or marked QRS widening with "shapeless" morphology — are all ECG indication of the need for immediate IV calcium until improvement of these ECG patterns.

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Ken Grauer, MD

OCTOBER 27, 2023

That said — obvious findings include: i ) Marked bradycardia! — Unfortunately, before this could be accomplished — the patient went into cardiac arrest. She was successfully resuscitated — with a post-arrest rhythm similar to that seen in Figure-1. Cardiac cath did not reveal significant coronary disease!

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Dr. Smith's ECG Blog

MAY 19, 2020

There is sinus bradycardia with one PVC. There is "Shark Fin morphology" I saw this and thought for certain that this was going to be an LAD or left main occlusion as etiology of arrest, and etiology of profound ST Elevation in I, II, aVL, and V3-V6, and ST depression in III, V1 and V2. She then had a 12-lead: What do you think?

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Dr. Smith's ECG Blog

OCTOBER 8, 2023

Smith: This bizarre ECG looks like a post cardiac arrest ECG with probable acidosis or hyperkalemia in addition to OMI. The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. Below the J-point is marked out showing the ST pathologic deviations. What was the pH and K? Potassium 4,6.

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Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 109

Dr. Smith's ECG Blog

MAY 26, 2023

Laddergram Illustration: The mechanism of AV block in ECG #2 is complex. I suspect there is dual-level Wenckebach out of the AV Node — as shown by my proposed laddergram that I've drawn in Figure-3 ( For more on the mechanism of dual-level AV block — CLICK HERE ).

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Dr. Smith's ECG Blog

MAY 6, 2019

This ECG pattern may be diagnostic of B rugada S yndrome IF seen in association with: i ) a history of cardiac arrest; polymorphic VT; or of non-vagal syncope; and / or ii ) a positive family history of sudden death at an early age; and / or iii ) a similar ECG in relatives. Bradycardia. Acute febrile illness. Hypothermia.

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Dr. Smith's ECG Blog

NOVEMBER 18, 2019

U waves may also be found in patients with LVH and/or bradycardia , or occasionally as a normal variant. Low body magnesium is often encountered in association with other electrolyte abnormalities ( ie, low sodium, potassium, calcium or phosphorus ) ; acute MI; cardiac arrest; digoxin/diuretic use; alcohol use and abuse; renal impairment.

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Dr. Smith's ECG Blog

DECEMBER 15, 2015

In any case, there is bradycardia. First, what kind of arrest was this? It was a PEA or bradyasystolic arrest , not a shockable rhythm. Although most cardiac arrest from MI is due to ventricular fibrillation, some is due to high grade AV block, and so this could indeed be due to large acute STEMI. What is going on?

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Dr. Smith's ECG Blog

NOVEMBER 25, 2022

These include ( among others ) — acute febrile illness — variations in autonomic tone — hypothermia — ischemia-infarction — malignant arrhythmias — cardiac arrest — and especially Hyperkalemia. Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ).

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Dr. Smith's ECG Blog

OCTOBER 11, 2020

About two hours after admission, he suffered a cardiac arrest (whether it was VF/VT or PEA is not available) and expired. The provider contacted cardiology to discuss the case, but cardiology "didn't think it was a STEMI, didn't think he needed emergent cath." He was admitted to the cardiology floor and diagnosed with an NSTEMI.

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Dr. Smith's ECG Blog

APRIL 15, 2019

If a patient presents with chest pain and a normal heart rate, or with shockable cardiac arrest, then ischemic appearing ST elevation is STEMI until proven otherwise. CLICK HERE — for the ESC/ACC/AHA/WHF 2018 Consensus Document on the 4th Universal Definition of MI, in which these concepts are discussed and illustrated.

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Tachycardia STEMI Chest Pain Ischemia 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

In addition to a spontaneous or induced Brugada-1 ECG pattern, criteria for B rugada S yndrome require one or more of the following: History of cardiac arrest, of polymorphoic VT, or of non-vagal syncope — positive family history of sudden death at an early age — a similar ECG in close relatives.

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Dr. Smith's ECG Blog

DECEMBER 5, 2019

Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep. Regardless of further evaluation, she should avoid bradycardia, AV nodal blockers, Na channel blockers, and fevers. --If

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