Bradycardia Ischemia Ultrasound 
Dr. Smith's ECG Blog
APRIL 14, 2024
No ischemia. Case continued Another ECG was recorded 3 hours later, still 1/10 pain: There is sinus bradycardia with RBBB. A bedside cardiac ultrasound performed by a true EM expert (Robert Reardon, who wrote the cardiac ultrasound chapter in Ma and Mateer) showed an inferior wall motion abnormality.
Dr. Smith's ECG Blog
JANUARY 2, 2025
Bedside cardiac ultrasound showed moderately decreased LV function. Discontinue all negative chronotropic agents, since the risk of torsade is much higher with bradycardia or pauses. She was intubated. CT of the chest showed no pulmonary embolism but bibasilar infiltrates. The plan: 1. Place temporary pacemaker 3.
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.
Dr. Smith's ECG Blog
JULY 21, 2024
There is no definite evidence of acute ischemia. (ie, Simply stated — t he patient was having recurrent PMVT without Q Tc prolongation, and without evidence of ongoing transmural ischemia. ( Some residual ischemia in the infarct border might still be present. Both episodes are initiated by an "R-on-T" phenomenon.
Dr. Smith's ECG Blog
DECEMBER 15, 2015
In any case, there is bradycardia. There is ST depression beyond the end of the wide QRS in I, II, aVF, and V4-V6, diagnostic of with subendocardial ischemia. A bedside cardiac ultrasound was recorded: Here is a still image of the echo: The red arrows outline the right ventricle and the yellow arrows outline the left ventricle chamber.
Dr. Smith's ECG Blog
AUGUST 9, 2024
However the patient continued to have chest pain and bedside ultrasound showed hypokinesis of the septum with significantly reduced LVEF. Possible mechanisms of ventricular arrhythmias elicited by ischemia followed by reperfusion. The receiving emergency physician consulted with interventional cardiology who stated there was no STEMI.
Dr. Smith's ECG Blog
FEBRUARY 23, 2023
Dr. Nossen performed a bedside ultrasound which was interpreted as normal. 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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