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What are these hyperacute T waves, with STE and T-wave inversion in aVL, and STD in inferior leads?

Dr. Smith's ECG Blog

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. We do not know for certain what the rhythm was?

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Tachycardia, fever to 105, and ischemic ST Elevation -- a Bridge too Far

Dr. Smith's ECG Blog

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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Transcutaneous Pacing: Part 2

EMS 12-Lead

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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STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

There is also bradycardia. Bradycardia puts patients at risk for "pause-dependent" Torsades de Pointes. Torsades in acquired long QT is much more likely in bradycardia because the QT interval following a long pause is longer still. If cardiac arrest from hypokalemia is imminent (i.e., mEq/L, from 1.9

STEMI 52
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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

In both tracings — an exceedingly fast PMVT is documented. There was no evidence bradycardia leading up to the runs of PMVT ( as tends to occur with Torsades ). Principal adverse cardiac effects of Quinidine include QRS widening and QTc prolongation. That said — there is no evidence on ECG of re-occlusion of the infarct artery.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. Drugs that have been associated with Brugada ECG patterns include tricyclic antidepressants, anesthetics, cocaine , methadone, antihistamines, electrolyte derangements, and even tramadol. [2].

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A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?

Dr. Smith's ECG Blog

Thus, Brugada is the likely diagnosis _ A very nice explanation of this is given in the document quoted below on current ECG criteria for Brugada pattern. Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep.