Bradycardia Diabetes Ischemia 
Dr. Smith's ECG Blog
OCTOBER 20, 2024
Written by Magnus Nossen The patient in today's case is a male in his 70s with hypertension and type II diabetes mellitus. The first task when assessing a wide complex QRS for ischemia is to identify the end of the QRS. His wife contacted the ambulance service after the patient experienced an episode of loss of consciousness.
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.
Dr. Smith's ECG Blog
MARCH 2, 2019
Diffuse ST depression with ST elevation in aVR: Is this pattern specific for global ischemia due to left main coronary artery disease? Ischemia b. Biphasic T-waves in a Middle-Aged Male with Vomiting Diabetic Ketoacidosis: is there hypokalemia? ST depression: is it ischemia? J Electrocardiol 2013;46:240-8. Hypokalemia c.
EMS 12-Lead
JUNE 1, 2022
Such findings would normally suggest primary ischemia with concomitant surveillance of coronary occlusion, but these ST/T changes might very well be secondary to the Escape mechanism at hand. Lead V2 shows RR’ QRS configuration, and although ST depression is otherwise expected here, the discordance is a bit excessive.
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.
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