Bradycardia Myocardial Infarction Ultrasound 
Dr. Smith's ECG Blog
APRIL 14, 2024
Case continued Another ECG was recorded 3 hours later, still 1/10 pain: There is sinus bradycardia with RBBB. But there are also new Q-waves, stronly suggesting new infarction. So we know there is myocardial infarction and the patient has persistent pain, but it is very mild. They only mask the underlying pathology.
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
AUGUST 9, 2024
However the patient continued to have chest pain and bedside ultrasound showed hypokinesis of the septum with significantly reduced LVEF. AIVR is not always the result of significant pathology, but is classically associated with the reperfusion phase of acute myocardial infarction. Do not treat AIVR.
Dr. Smith's ECG Blog
JULY 21, 2024
Troponin T peaked at 38,398 ng/L ( = a very large myocardial infarction, but not massive-- thanks to the pre-PCI spontaneous reperfusion, and rapid internvention!! ). Some residual ischemia in the infarct border might still be present. Over the next couple of days the patient was weaned off of mechanical circulatory support.
Dr. Smith's ECG Blog
MAY 30, 2023
Here is his ED ECG: There is bradycardia with a junctional escape. Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia. Posterior wall involvement attenuates predictive value of ST-segment elevation in lead V4R for right ventricular involvement in inferior acute myocardial infarction.
Dr. Smith's ECG Blog
APRIL 8, 2016
Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. There is also bradycardia. Bradycardia puts patients at risk for "pause-dependent" Torsades de Pointes. Literature on Hypokalemia as a risk for ventricular fibrillation in acute myocardial infarction.
Dr. Smith's ECG Blog
JANUARY 5, 2024
The ECG shows sinus bradycardia but is otherwise normal. So there is probability of myocardial injury here (and because it is in the correct clinical setting, then myocardial infarction.) The documentation does not describe any additional details of the history. The following ECG was obtained. ECG 1 What do you think?
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