Circulation

NOVEMBER 11, 2024

Electrocardiogram (ECG) and telemetry revealed junctional bradycardia with heart rate in 30s and sinus pauses (5-7 seconds). He was admitted for further workup of bradycardia. His home medications included metoprolol succinate 25mg daily which was held given bradycardia. Initial laboratory analysis was unremarkable.

Bradycardia 40

Bradycardia Coronary Artery Disease Kidney Disease Outpatient 40

Physiologically Speaking

JULY 26, 2024

We talk about the ketogenic diet as a metabolic therapy for type 1 diabetes. Dozens if not hundreds of (albeit observational) studies have linked a short sleep duration to a number of health conditions including type 2 diabetes and cardiovascular disease. Welcome to the Physiology Friday newsletter.

Chronic Disease 64

Chronic Disease Physiology Atrial Flutter Atrial Fibrillation 64

Dr. Smith's ECG Blog

JANUARY 5, 2024

Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." The ECG shows sinus bradycardia but is otherwise normal. The documentation does not describe any additional details of the history. The following ECG was obtained. ECG 1 What do you think?

Angina 120

Angina Plaque Document Stent 120

EMS 12-Lead

MARCH 19, 2023

He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. Breath sounds were clear in all lung fields. No appreciable skin pallor. He reported to be a social drinker, but used tobacco products daily.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

Dr. Smith's ECG Blog

JANUARY 28, 2018

He has a history of known CAD, diabetes, and dyslipidemia. Here is his previous ECG: This was my interpretation of the first ECG: Sinus bradycardia with less than 1mm ST elevation in V4-V6, elevated compared to the previous ECG, suggestive of lateral MI. By pure clinical appearance, he looked like the textbook patient with acute MI.

Pericarditis 52

Pericarditis Ischemia STEMI Chest Pain 52

Dr. Smith's ECG Blog

JUNE 23, 2023

A 50-something male with unspecified history of cardiomyopathy presented in diabetic ketoacidosis (without significant hyperkalemia) with a wide complex tachycardia and hypotension. The patient later settled into sinus bradycardia. Bedside echo showed "mildly reduced" LV EF. Here is the ED ECG: What do you think? It is regular.

Tachycardia 52

Tachycardia Cardiomyopathy Arrhythmia Diabetes 52

Dr. Smith's ECG Blog

MARCH 2, 2019

Biphasic T-waves in a Middle-Aged Male with Vomiting Diabetic Ketoacidosis: is there hypokalemia? In my experience, Ive seen U waves not only with low K+/low Mg++ but also in patients with bradycardia, LVH, and sometimes in normal subjects. You probably think it is left main. Are These Wellens' Waves?? ST depression: is it ischemia?

Sickle Cell Disease 52

Sickle Cell Disease Ischemia Dysrhythmia Chest Pain 52