Dr. Smith's ECG Blog

FEBRUARY 23, 2023

After the heart rate increased slightly, here was the repeat ECG: Sinus bradycardia, only slightly faster rate than prior. Learning Points: Ectopic atrial rhythm can produce atrial repolarization findings that can be confused for acute ischemia, STEMI, or OMI.

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Blog Bradycardia Ischemia Exercise 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2017

Case 4 Transient STEMI, serial ECGs prehospital to hospital, all troponins negative (less than 0.04 Patient presentation is important This was a 60-something with acute chest pain: There is sinus bradycardia at a rate of 44. In case you were wondering about the T-waves and bradycardia, the K was normal. Why bradycardia?

Chest Pain 52

Chest Pain STEMI Bradycardia Stenosis 52

Dr. Smith's ECG Blog

JANUARY 23, 2023

Triage physician interpretation: -sinus bradycardia -lateral ST depressions While there are lateral ST depressions (V5, V6) the deepest ST depressions are in V4. Ischemic ST-Segment Depression Maximal in V1-V4 (Versus V5-V6) of Any Amplitude Is Specific for Occlusion Myocardial Infarction (Versus Nonocclusive Ischemia). 121.022866.

Chest Pain 52

Chest Pain Blog Stenosis Myocardial Infarction 52

Dr. Smith's ECG Blog

OCTOBER 7, 2019

Both of these features make inferior + RV MI by far the most likely ( Pseudoanteroseptal MI is another name for this ) There is also sinus bradycardia and t he patient is in shock with hypotension. A narrow complex bradycardia without any P-waves is also likely to respond to atropine, as it may be a junctional rhythm.

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Bradycardia STEMI Cardiogenic Shock Ischemia 40

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The first task when assessing a wide complex QRS for ischemia is to identify the end of the QRS. The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch). What do you think?

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Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 127

Dr. Smith's ECG Blog

OCTOBER 25, 2023

A prior ECG was available for comparison: Normal One might be tempted to interpret the ST depression as ischemia, but as Smith says, "when the QT is impossibly long, think of hypokalemia and a U-wave rather than T-wave." The patient was admitted to the ICU for close monitoring and electrolyte repletion and had an uneventful hospital course.

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Chest Pain Ischemia Cardiac Arrest Blog 123

Dr. Smith's ECG Blog

JULY 21, 2024

The patient was extubated on Day-3 of the hospital stay. The patient improved, and on Day-11 of the hospital stay — he was off inotropes and on a small dose of a ß-blocker. There is no definite evidence of acute ischemia. (ie, Some residual ischemia in the infarct border might still be present.

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 130

Dr. Smith's ECG Blog

APRIL 8, 2016

There is also bradycardia. Bradycardia puts patients at risk for "pause-dependent" Torsades de Pointes. Torsades in acquired long QT is much more likely in bradycardia because the QT interval following a long pause is longer still. The corrected QT interval is extremely long, about 500 ms. However, the mean level (2.50.4

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STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Wellnest

DECEMBER 21, 2022

Patients use them to observe their heart activity by themselves when they are not in the hospital. Though their accuracy is not as high as a hospital ECG machine, they are very beneficial in detecting problems in any medical emergency and providing information about long-term heart activity.

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Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

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. Hospital transport was unremarkable. The patient advised overall improvement with complete resolution of symptoms.

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Heart Failure Myocardial Infarction Bradycardia Chest Pain 52

Dr. Smith's ECG Blog

MAY 5, 2022

A few days later an ECG was repeated which showed normal sinus rhythm with no further hyperkalemia findings: After a 3-week hospitalization for acute renal failure, hyperkalemia, and compartment syndrome, the patient was discharged to acute rehab. He went emergently to the OR for fasciotomy due to compartment syndrome. With a twist.

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Evidence of acute ischemia (may be subtle) vii. PVCs N ot generally considered abnormal ECG findings: Isolated PAC, First Degree AV Block, Sinus bradycardia at a rate of 35-45, and Nonspecific ST-T abnormalities (even if different from a previous ECG). Left BBB vi. Pathologic Q-waves viii. LVH or RV d. Abnormal but less worrisome: i.

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Arrhythmia Outcomes Chest Pain Risk Factors 52

Dr. Smith's ECG Blog

MARCH 19, 2025

Despite the baseline artifact theres sinus bradycardia, convex ST elevation in III, reciprocal ST depression in aVL and possible anterior ST depression indicating inferoposterior OMI. 7 steps to missing posterior Occlusion MI, and how to avoid them Interventionalist at the Receiving Hospital: "No STEMI, no cath.

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