Dr. Smith's ECG Blog

FEBRUARY 27, 2023

There is often missing documentation as to when which ECG was recorded at the time of which blood draw ( and whether any treatment had yet been initiated ). And, there is no documentation that the tachycardia has resolved. mEq/L K+ value may ( or may not ) closely correlate to the timing of today's ECG.

Tachycardia 52

Tachycardia Document Blog Bradycardia 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

If cardiac arrest from hypokalemia is imminent (i.e., Document in the patient's chart that rapid infusion is intentional in response to life-threatening hypokalemia." As I indicated above, in our cardiac arrest case, after pushing 40 mEq, the K only went up to 4.2 How would you treat? mEq/L, from 1.9

Cardiac Arrest 40

Cardiac Arrest Tachycardia Nursing Ultrasound 40

Dr. Smith's ECG Blog

JULY 27, 2023

While hypertension and sinus tachycardia are the most common manifestations — a variety of other tachyarrhythmias ( including VT leading to cardiac arrest ) and acute MI may be seen. Potential cardiovascular effects of acute amphetamine use are multiple. An OMI is always a possibility with acute amphetamine use.

Tachycardia 52

Tachycardia Ischemia Cardiac Arrest Echocardiogram 52

Dr. Smith's ECG Blog

APRIL 15, 2019

If a patient presents with chest pain and a normal heart rate, or with shockable cardiac arrest, then ischemic appearing ST elevation is STEMI until proven otherwise. CLICK HERE — for the ESC/ACC/AHA/WHF 2018 Consensus Document on the 4th Universal Definition of MI, in which these concepts are discussed and illustrated.

Tachycardia 40

Tachycardia STEMI Chest Pain Ischemia 40

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

This patient was reported to have distant heart sounds but was not hypotensive and did not have JVD according to documentation. Beck’s triad only happens all 3 together in approximately 1/3rd of patients. Smith comment : First, IV fluids are indicated to improve preload.

Pericarditis 40

Pericarditis Tachycardia Ultrasound Blood Pressure 40

CardiacWire

FEBRUARY 7, 2025

The “weekend effect” is a well-documented phenomenon in hospital care, often linked to reduced staffing levels, leading to potential delays in diagnosis and intervention. Weekend procedures also face limited access to specialized cardiac teams, affecting timely decisions and making urgent procedures more difficult to schedule.

TAVR 59

TAVR Cardiogenic Shock Hospital Cardiac Arrest 59

Ken Grauer, MD

JULY 29, 2023

The ECG in Figure-1 was obtained from an 18-year old woman — who moments before been resuscitated from out-of-hospital cardiac arrest. Does this ECG in Figure-1 provide clue(s) to the etiology of this patient's cardiac arrest? I suspected the answer resides in the reason why an 18-year woman might have a cardiac arrest.

Blog 148

Blog Cardiac Arrest Cardiomyopathy Hospital 148

EMS 12-Lead

MAY 15, 2024

Patient had an unwitnessed cardiac arrest without bystander CPR performed. The crew increases this current to 75mA and documents an “improvement in patient status” with palpated pulses and a BP of 115/60. Per protocol, respirators, eye protection, and gowns were donned prior to contact. This set current is seen in Figure 5.

Bradycardia 132

Bradycardia Atrial Fibrillation Pacemaker Cardiac Arrest 132

Dr. Smith's ECG Blog

APRIL 8, 2016

If cardiac arrest from hypokalemia is imminent (i.e., As I indicated above, in our cardiac arrest case, after pushing 40 mEq, the K only went up to 4.2 For comparison, the same variables were reviewed for 62 consecutive patients who had transmural acute myocardial infarction (AMI) without cardiac arrest.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

HeartRhythm

SEPTEMBER 10, 2023

A few decades ago all sudden cardiac arrests with documented ventricular fibrillation (VF) and structurally normal hearts were diagnosed as idiopathic ventricular fibrillation (IVF).

Electrocardiogram 40

Electrocardiogram Sudden Cardiac Death Cardiac Arrest Document 40

Frontiers in Cardiovascular Medicine

OCTOBER 8, 2024

ObjectiveAlthough the association between admission glucose (AG) and major adverse cardiac events (MACE) is well-documented, its relationship with 30-day MACE in patients presenting with cardiac chest pain remains unclarified.

Chest Pain 52

Chest Pain Cardiogenic Shock Cardiac Arrest Myocardial Infarction 52

All About Cardiovascular System and Disorders

OCTOBER 25, 2023

The study documented that catheter ablation for AF in patients with heart failure was associated with a significantly lower rate of a composite endpoint of death from any cause or hospitalization for worsening heart failure, than medical therapy. 2019 Apr 2;321(13):1261-1274. doi: 10.1001/jama.2019.0693. PMID: 30874766; PMCID: PMC6450284.

Atrial Fibrillation 52

Atrial Fibrillation Heart Failure Ablation Cardiac Arrest 52

Dr. Smith's ECG Blog

JULY 21, 2024

In both tracings — an exceedingly fast PMVT is documented. The schematic grouping below reviews classification of PMVT types: In today's case — the sinus-conducted beats prior to and between the episode of PMVT show evidence of completed anterior wall MI. That said — there is no evidence on ECG of re-occlusion of the infarct artery.

Arrhythmia 130

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 130

Circulation

NOVEMBER 27, 2024

BACKGROUND:Declining cardiovascular mortality rates have been well-documented, yet temporal trends of sudden cardiac death (SCD) in young individuals remain unclear.

Sudden Cardiac Death 49

Sudden Cardiac Death Defibrillator Cardiac Arrest Certification 49

Dr. Smith's ECG Blog

JULY 22, 2023

Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. Drugs that have been associated with Brugada ECG patterns include tricyclic antidepressants, anesthetics, cocaine , methadone, antihistamines, electrolyte derangements, and even tramadol. [2].

Chest Pain 92

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 92

All About Cardiovascular System and Disorders

OCTOBER 26, 2023

Spontaneous type 1 ECG has the highest number of points at 3.5, while fever-induced type 1 ECG has 3 points. Type 2/3 ECG which gets converted to type 1 pattern with sodium channel blockers have 2 points.

Sudden Cardiac Death 52

Sudden Cardiac Death Atrial Fibrillation Electrophysiology Arrhythmia 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. Drugs that have been associated with Brugada ECG patterns include tricyclic antidepressants, anesthetics, cocaine , methadone, antihistamines, electrolyte derangements, and even tramadol. [2].

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

ECG Cases

DECEMBER 3, 2024

On this month's EM Quick Hits podcast: Ross Prager on TEE in cardiac arrest, Justin Morgenstern on nebulized ketamine for analgesia in the ED, Hans Rosenberg & Krishin Yadav on standardizing cellulitis management, Mathew McArther on latest studies on subcutaneous insulin protocols in DKA, Jennifer C.

Cardiac Arrest 110

Cardiac Arrest Document 110

Circulation

NOVEMBER 11, 2024

They increase the risk of hypertension, coronary artery disease, coronary vasospasm, arrhythmias, cardiomyopathy, cardiac arrest, and stroke. Introduction:Cocaine and methamphetamine, stimulants with potent central nervous system effects, are known to be cardiotoxic.

Cardiovascular Disease 40

Cardiovascular Disease Coronary Artery Disease Cerebrovascular Disease Cardiac Arrest 40

Dr. Smith's ECG Blog

DECEMBER 5, 2019

Thus, Brugada is the likely diagnosis _ A very nice explanation of this is given in the document quoted below on current ECG criteria for Brugada pattern. Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep.

Sudden Cardiac Death 52

Sudden Cardiac Death Heart Rhythm Article Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 13, 2025

Unexplained cardiac arrest or documented VF/polymorphic VT: +3 3. Unexplained sudden cardiac death (3 categories) (+0.5 - +2) 4. Cardiac arrest. Clinical History 2.a. of atrial fib/flutter at age less than 30: +0.5 syncope of unclear etiology: +1 2.c. Suspected arrhythmic syncope: +2 2.d. Family History 3.a.

Chest Pain 70

Chest Pain Cardiac Arrest Ischemia Sudden Cardiac Death 70

Dr. Smith's ECG Blog

APRIL 18, 2025

If the ventricular escape rhythm also gives out, the patient has cardiac arrest. He suffered another cardiac arrest in the ICU with ROSC after another dose of epinephrine and one round of CPR. After discussion with the patients family, the decision was made not to resuscitate in the event of re-arrest.

Chest Pain 80

Chest Pain Cardiac Arrest Tachycardia ICU 80