Bradycardia Cardiomyopathy Chest Pain 
Dr. Smith's ECG Blog
JUNE 5, 2024
The patient presented due to chest pain that was typical in nature, retrosternal and radiating to the left arm and neck. He denied any exertional chest pain. It is unclear if the patient was pain free at this time. He has a medical hx notable for hypertension, hyperlipidemia and previous tobacco use disorder.
Dr. Smith's ECG Blog
JULY 5, 2023
The patient has acute chest pain. Instead — my thoughts were as follows: The rhythm is sinus , with marked bradycardia and a component of sinus arrhythmia. This was texted to me in real time. What do you think? Here was my answer: "Not ischemia. Maybe HOCM or another form of LVH. I would not activate cath lab.
Dr. Smith's ECG Blog
OCTOBER 18, 2023
The chest pain quickly subsided. During the night, while on telemetry, the patient became bradycardic, with periods of isorhythmic AV dissociation (nodal escape rhythm alternating with sinus bradycardia), and there were sporadic PVCs. An MRI was deemed unnecessary at the diagnosis of stress cardiomyopathy was concidered certain.
Dr. Smith's ECG Blog
NOVEMBER 11, 2023
Later, I found old ECGs: 5 month prior in clinic: V5 and V6 look like OMI 9 months prior in clinic with no chest symptoms: V5 and V6 look like OMI 1 year prior in the ED with chest pain: V5 and V6 sure look like a STEMI For this ECG and chest pain in the ED, the Cath lab activated. But the angiogram was clean.
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. Thus, there is a wall motion abnormality in the distribution of the LAD (not global apical dyskinesis, as in takostubo). Clinical Context is everything !
Dr. Smith's ECG Blog
DECEMBER 5, 2016
(This ECG could easily be seen in an ED chest pain patient, and I have seen many) What do you think? Description Sinus bradycardia. There is ST elevation in V2 and V3 There are inverted T-waves in V2 and V3 There are prominent U-waves in V2 and V3 Many responders were worried about ischemia or hypertrophic cardiomyopathy.
Dr. Smith's ECG Blog
JANUARY 23, 2024
There was no chest pain. The granulomatous inflammation affects the heart, causing an infiltrative cardiomyopathy The most common manifestations of cardiac sarcoidosis are atrioventricular (AV) block and ventricular tachyarrhythmias (VT). This was written by Magnus Nossen The patient is a female in her 50s.
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