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 52

Bradycardia Cardiogenic Shock STEMI Ischemia 52

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. 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. The culprit was opened and stented.

Chest Pain 102

Chest Pain Ischemia Myocardial Infarction Ultrasound 102

Dr. Smith's ECG Blog

JANUARY 5, 2024

The ECG shows sinus bradycardia but is otherwise normal. On intravascular ultrasound (IVUS), the mid RCA plaque was described as "cratered, inflamed, and bulky," and the OM plaque was described as "bulky with evidence of inflammation and probably ulceration." RCA and PDA before and after, arrows indicating stented regions.

Angina 101

Angina Plaque Document Stent 101

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

Arrival at time 0 ECG 7 min Roomed in hallway at 17 min Moved to room with monitor at 37 min The patient was seen briefly by the physician, who then went to get an ultrasound machine. He has a h/o of 3 vessel disease and stents and his pain has been on and off for days. Then he was placed in a room after 30 minutes.

Chest Pain 126

Chest Pain Defibrillator STEMI Coronary Artery Disease 126

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. Angiogram: Culprit Lesion (s): Thrombotic occlusion of the proximal RCA -- stented. He appeared gray in color, with cool skin. What is the atrial activity?

Chest Pain 74

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 74

Dr. Smith's ECG Blog

NOVEMBER 3, 2017

After many hours, the decided that it was appropriate to do an angiogram and they found a distal LAD occlusion which was opened and stented. Patient presentation is important This was a 60-something with acute chest pain: There is sinus bradycardia at a rate of 44. Why bradycardia? It was stented. STE60V3 = 2.5

Chest Pain 52

Chest Pain STEMI Bradycardia Stenosis 52