Dr. Smith's ECG Blog

APRIL 6, 2018

There is a regular, wide complex, (mostly) monomorphic tachycardia. The differential of wide, regular, monomorphic tachycardia is: VT or SVT with aberrancy, all +/- hyperkalemia (see diagrams below). He made it to the ICU, however the patient unfortunately expired approximately 24 hours after ICU admission.

Cardiac Arrest 52

Cardiac Arrest Tachycardia Defibrillator ICU 52

Dr. Smith's ECG Blog

JULY 24, 2018

Prior ECG on file: Sinus tachycardia, imperfect baseline, otherwise unremarkable. Sinus tachycardia with unequivocal evidence of hyperkalemia, including widened QRS with "pulled apart" morphology (widened QRS) compared to baseline, as well as clearly peaked T-waves. He required a low dose norepinephrine drip to maintain BP.

Cardiac Arrest 52

Cardiac Arrest Tachycardia Chest Pain ICU 52

Dr. Smith's ECG Blog

MAY 5, 2022

After initiating treatment for hyperkalemia, repeat ECG showed resolution of Brugada pattern: The ECG shows sinus tachycardia. He was admitted to the ICU and transferred emergently to a facility where he could undergo emergent dialysis as a part of further evaluation and management. The QRS is narrow and T waves are much less peaked.

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 52

Dr. Smith's ECG Blog

OCTOBER 25, 2023

ECG is consistent with severe hypokalemia and/or hypomagnesemia causing prolonged QT (QU) at high risk of Torsades (which is polymorphic ventricular tachycardia in the setting of a long QT interval). The patient was admitted to the ICU for close monitoring and electrolyte repletion and had an uneventful hospital course. Is it STEMI?

Ischemia 116

Ischemia Chest Pain Cardiac Arrest Blog 116