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
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. They only mask the underlying pathology.
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." The documentation does not describe any additional details of the history.
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. BP was 108 systolic (if a cuff pressure can be trusted) but appeared to be maintaining BP only by very high systemic vascular resistance. What is the atrial activity?
All About Cardiovascular System and Disorders
APRIL 14, 2024
Use of drugs producing bradycardia like beta blockers in stages III and IV may precipitate low output state. J Cardiovasc Ultrasound. J Cardiovasc Ultrasound. In stage IV, this restrictive filling pattern remains fixed even during Valsalva maneuver. Initial stages (I to III) are considered reversible with treatment. Ha J et al.
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. That said — what is unusual about the rhythm in the initial ECG of today's case — is the marked bradycardia!
Dr. Smith's ECG Blog
MAY 19, 2020
There is sinus bradycardia with one PVC. The ways to tell for certain include intravascular ultrasound (to look for extra-luminal plaque with rupture) or "optical coherence tomography," something I am entirely unfamiliar with. She then had a 12-lead: What do you think?
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