Dr. Smith's ECG Blog

JUNE 5, 2024

IMPRESSION: The finding of sinus bradycardia with 1st-degree AV block + marked sinus arrhythmia + the change in PR interval from beat #5-to-beat #6 — suggests a form of vagotonic block ( See My Comment in the October 9, 2020 post in Dr. Initial high sensitivity troponin I returned at 6ng/L (normal 0.20

Chest Pain 106

Chest Pain Blog Cardiac Arrest Cardiomyopathy 106

Dr. Smith's ECG Blog

JUNE 19, 2023

Soon afterward, the patient’s symptoms return along with lightheadedness, bradycardia, and hypotension. The patient has also developed sinus bradycardia, which may result from right coronary artery ischemia to the SA node. The Queen of Hearts agrees: Around this time his initial high sensitivity troponin I resulted at 231 ng/L.

Chest Pain 52

Chest Pain STEMI Cardiogenic Shock Ischemia 52

EMS 12-Lead

MARCH 19, 2023

Perhaps a more balanced approach is that this could equally have been a case where the patient arrives to the ED, is worked up for “non-specific” ST changes and, in the process of such a disposition, is allowed to infarct transmurally while awaiting next-day coronary angiogram where reduced LV systolic function is encountered.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

A coronary angiogram was done that did not show significant coronary artery disease. Had there been recurrent episodes of pause-dependent TdP, temporary ventricular pacing at a higher heart rate would have been indicated to suppress the pauses and in that way decreasing the risk of further episodes of TdP.

Cardiac Arrest 67

Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 67

Dr. Smith's ECG Blog

JUNE 19, 2024

Three months prior to this presentation, he received a pacemaker for severe bradycardia and syncope due to sinus node dysfunction. The ED provider ordered a coronary CT scan to assess the patient for CAD. The patient was taken emergently to the cath lab for a pericardiocentesis instead of a coronary angiogram.

Chest Pain 60

Chest Pain Pericarditis Pacemaker STEMI 60

Dr. Smith's ECG Blog

DECEMBER 22, 2022

His first electrocardiogram ( ECG) is given below: --Sinus bradycardia. Here is the coronary angiogram: A distal thrombotic right coronary artery (RCA) occlusion ! Blood pressure: 130/80 mmHg, heart rate: 45/min, respiratory rate: 18/min, SaO2: %98, body temperature: normal. No reciprocal ST-segment depression (STD). --QT

STEMI 52

STEMI Chest Pain Myocardial Infarction Electrocardiogram 52