Dr. Smith's ECG Blog

APRIL 8, 2016

Here is his ED ECG: There is obvious infero-posterior STEMI. What are you worried about in addition to his STEMI? Comments: STEMI with hypokalemia, especially with a long QT, puts the patient at very high risk of Torsades or Ventricular fibrillation (see many references, with abstracts, below). There is atrial fibrillation.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

He had multiple cardiac arrests with ROSC regained each time. Then there is loss of pulses with continued narrow complex on the monitor ("PEA arrest") Learning Points: Sudden witnessed Cardiac Arrest due to ACS is almost always due to dysrhythmia. This patient arrested shortly after hospital arrival.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52

Dr. Smith's ECG Blog

FEBRUARY 2, 2017

So the real QT is shorter, but the computer does not mention the U-wave, and the U-wave is as important as the T-wave in predicting cardiac dysrhythmias. 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

Cardiac Arrest 52

Cardiac Arrest Dysrhythmia Arrhythmia Nursing 52

Dr. Smith's ECG Blog

JULY 22, 2023

A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. There were no dysrhythmias on cardiac monitor during observation. So maybe she is better than I am. He was found to be influenza positive. Is there fever again?

Chest Pain 92

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 92

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

If cardiac arrest from hypokalemia is imminent (i.e., to greatly decrease risk (although in STEMI, the optimal level is about 4.0-4.5 As I indicated above, in our cardiac arrest case, after pushing 40 mEq, the K only went up to 4.2 Give an initial infusion of 10 mEq IV over 5 minutes; repeat once if needed.

Cardiac Arrest 40

Cardiac Arrest Tachycardia Nursing Ultrasound 40

Dr. Smith's ECG Blog

JANUARY 30, 2019

2) The STE in V1 and V2 has an R'-wave and downsloping ST segments, very atypical for STEMI. Cardiology was consulted and they agreed that the EKG had an atypical morphology for STEMI and did not activate the cath lab. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Bicarb 20, Lactate 4.2,

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52