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
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.
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.
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.
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
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