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.
Stroke: Vascular and Interventional Neurology
FEBRUARY 6, 2024
OBJECTIVECarotid artery stenting for heavily calcified lesions is challenging for interventionists. Sufficient dilatation was achieved, followed by carotid stent deployment (Precise Pro RX; Cordis, Miami Lakes, FL, USA). Stroke: Vascular and Interventional Neurology, Ahead of Print.
Dr. Smith's ECG Blog
AUGUST 11, 2024
There’s competing sinus bradycardia and junctional rhythm, with otherwise normal conduction, borderline right axis, normal R wave progression and voltages. Cath lab was activated, and found a 95% proximal LAD occlusion which was stented. Significant bradycardia ( rate in the 40s/minute ) — is present throughout.
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
The role of intracranial stenting in ICAS remains uncertain. In the SAMMPRIS trial, patients who had experienced recent TIA/CVA secondary to 70‐99% ICAS demonstrated an increased risk of recurrent stroke when treated with angioplasty and stenting compared to medical therapy alone [1].
Dr. Smith's ECG Blog
SEPTEMBER 11, 2024
Former resident: "Just saw cath report, LAD stent was 100% acutely occluded." They of course opened and stented it. They said it looked similar to his old one (in my opinion, similar, but not similar enough to be able to say no OMI)." Smith : "What was the outcome?" You taught us well!"
Dr. Smith's ECG Blog
MARCH 22, 2024
I will leave more detailed rhythm discussion to the illustrious Dr. Ken Grauer below, but this use of calipers shows that the rhythm interpretation is: Sinus bradycardia with a competing (most likely junctional) rhythm. preceding each of the fascicular beats — indicating a faster rate for the escape rhythm compared to the sinus bradycardia ).
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. The culprit was opened and stented. They only mask the underlying pathology. Aspirin and heparin were given, but no NTG. There is minimal STE in I and aVL, but this can be quite normal in RBBB.
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