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. Analysis: there is a wide complex tachycardia. This was the interpretation I put into the system: WIDE COMPLEX TACHYCARDIA. It is regular.

Tachycardia 52

Tachycardia Cardiomyopathy Arrhythmia Diabetes 52

Dr. Smith's ECG Blog

OCTOBER 8, 2023

Remember, in diffuse subendocardial ischemia with widespread ST-depression there may b e ST-E in lead s aVR and V1. There are well formed R-waves with good voltage/amplitude which is uncommon for ischemia. The ECG does not show any signs of ischemia. True Positive ECG#2 : Also sinus rhythm. There is ST depression in V1.

Ischemia 126

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 126

Dr. Smith's ECG Blog

JULY 5, 2018

during which sinus bradycardia and arrhythmia are seen but not to a degree that produces symptoms. Thus, there is sinus bradycardia and arrhythmia sinus pauses ( which may be longlasting, ultimately leading to sinus arrest ) and SA nodal block. The indication for pacemaker placement with SSS is symptomatic bradycardia.

Atrial Fibrillation 52

Atrial Fibrillation AFIB Bradycardia Pacemaker 52

Dr. Smith's ECG Blog

OCTOBER 15, 2024

Whether these EKGs show myocarditis, a normal variant, or something else, they are overall not typical of transmural ischemia of the anterior or high lateral walls. He had multiple episodes of bradycardia and nonsustained ventricular tachycardia. The patient had none of these conditions. It was stented.

Chest Pain 119

Chest Pain STEMI Echocardiogram Stent 119

Dr. Smith's ECG Blog

JANUARY 21, 2023

This ECG shows a sinus bradycardia with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, normal R-wave progression, normal voltages. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. There is marked sinus bradycardia. What do you think? Pacing Clin Electrophysiol.

STEMI 52

STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Wellnest

DECEMBER 21, 2022

A fast heartbeat is called tachycardia, while a slow heartbeat is called bradycardia in medical terms. Poor blood supply Ischemia, or inadequate blood supply to the heart, is an abnormality that can be detected in an ECG test. Arrhythmia In simple words, arrhythmia refers to an irregular heartbeat.

Cardiac Arrest 52

Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

Ken Grauer, MD

JUNE 2, 2023

to 1828 msec. ) — which corresponds to a variation in the rate of sinus bradycardia from 36-to-33/minute. This makes sense given that the underlying rhythm in today's case appears to be marked sinus bradycardia and arrhythmia , with a ventricular escape rhythm appearing when the SA node rate drops below 33/minute.

Blog 78

Blog Bradycardia Arrhythmia Tachycardia 78

Dr. Smith's ECG Blog

OCTOBER 18, 2023

During the night, while on telemetry, the patient became bradycardic, with periods of isorhythmic AV dissociation (nodal escape rhythm alternating with sinus bradycardia), and there were sporadic PVCs. The above ECGs show the initiation and continuation of a polymorphic ventricular tachycardia.

Cardiac Arrest 126

Cardiac Arrest Tachycardia Cardiomyopathy Bradycardia 126

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. The Initial ECG in Today's Case: As per Dr. Meyers — the initial ECG in today's case shows sinus tachycardia with bifascicular block ( = RBBB/LAHB ). Sinus Tachycardia ( common in any trauma patient. ).

Tachycardia 118

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 118

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. ST elevation in aVL with reciprocal ST depression in the inferior leads Shock, bradycardia, ST Elevation in V1 and V2. He also received insulin with D50, sodium bicarbonate, and kayexalate for hyperkalemia.

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 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.

Bradycardia 40

Bradycardia Cardiogenic Shock STEMI Ischemia 40

Dr. Smith's ECG Blog

AUGUST 9, 2024

Automatic activity refers to enhanced pacemaking function (typically from a non sinus node source), for example atrial tachycardia. Possible mechanisms of ventricular arrhythmias elicited by ischemia followed by reperfusion. The most common triggered arrhythmia is Torsades de Pointes. Do not treat AIVR. References: Ferrier, G.

Chest Pain 111

Chest Pain Arrhythmia Myocardial Infarction STEMI 111

Dr. Smith's ECG Blog

APRIL 29, 2020

A useful classification of WCT ( W ide- C omplex T achycardia ) rhythms — separates them into those that are mono morphic ( with similar QRS morphology during the tachycardia ) vs those that are poly morphic ( in which QRS morphology varies ). Acute ischemia? Use of QT-prolonging drugs?

Cardiac Arrest 52

Cardiac Arrest Defibrillator Tachycardia Ischemia 52

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. See here for management of Polymorphic Ventricular Tachycardia , which includes Torsades.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

NOVEMBER 18, 2019

U waves may also be found in patients with LVH and/or bradycardia , or occasionally as a normal variant. This is often quite challenging to recognize — but the finding of negative U waves in a patient with chest pain is highly suggestive of ischemia ! N OTE # 1 — U waves are not specific for hypokalemia! second ).

Chest Pain 52

Chest Pain Cardiac Arrest Bradycardia Tachycardia 52

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. ST depression: is it ischemia? 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.

Sickle Cell Disease 52

Sickle Cell Disease Ischemia Dysrhythmia Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

Otherwise vitals after intubation were only notable for tachycardia. An initial EKG was obtained: Computer read: sinus tachycardia, early acute anterior infarct. She was ventilated by bag-valve-mask by EMS on arrival and was quickly intubated with etomidate and succinylcholine. A rectal temperature was obtained which read 107.9

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

These include ( among others ) — acute febrile illness — variations in autonomic tone — hypothermia — ischemia-infarction — malignant arrhythmias — cardiac arrest — and especially Hyperkalemia. Sinus Tachycardia ( common in any trauma patient. ).

Arrhythmia 52

Arrhythmia Blog Chest Pain Cardiac Arrest 52

Dr. Smith's ECG Blog

APRIL 8, 2015

If the patient has Abnormal Vital Signs (fever, hypotension, tachycardia, or tachypnea, or hypoxemia), then these are the primary issue to address, as there is ongoing pathology which must be identified. Evidence of acute ischemia (may be subtle) vii. Most physicians will automatically be worried about these symptoms. Left BBB vi.

Arrhythmia 52

Arrhythmia Chest Pain Risk Factors Outcomes 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). That said there were no clinical symptoms or ECG findings suggestive of ongoing ischemia. This patient very likely has some form of idiopathic ventricular tachycardia. No PVCs are seen.

Tachycardia 75

Tachycardia Arrhythmia Atrial Flutter Ablation 75

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

There was never ventricular fibrillation (VF) or ventricular tachycardia (VT), no shockable rhythm. Here is a similar case: Collapse, Ventricular Tachycardia, Cardioverted, Comatose on Arrival. Agitation, Confusion, and Unusual Wide Complex Tachycardia. There is sinus tachycardia at ~115/minute.

STEMI 91

STEMI Hemorrhage Cardiac Arrest Tachycardia 91