Dr. Smith's ECG Blog

JANUARY 2, 2025

Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates. See this post: How a pause can cause cardiac arrest 2. Even with tachycardia and a paced QRS duration of ~0.16 She was intubated. The plan: 1. Place temporary pacemaker 3.

Tachycardia 115

Tachycardia Cardiomyopathy Blog Bradycardia 115

Dr. Smith's ECG Blog

SEPTEMBER 29, 2024

Although one may have all kinds of ischemic findings as a result of cardiac arrest (rather than cause of cardiac arrest), this degree of ST elevation and HATW is all but diagnostic of acute proximal LAD occlusion. This prompted cath lab activation. On arrival to the ED, this ECG was recorded: What do you think?

Cardiac Arrest 109

Cardiac Arrest STEMI Ischemia SCAD 109

Dr. Smith's ECG Blog

JANUARY 8, 2024

Smith interpretation: This is highly likely to be due to extreme right heart strain and is nearly diagnostic of pulmonary embolism. What is the clear diagnosis and reason for arrest? It is of course pulmonary embolism. KEY Findings in ECG #1 include the following: Sinus tachycardia at ~110/minute.

Chest Pain 70

Chest Pain Pulmonary Embolism STEMI 70

Dr. Smith's ECG Blog

OCTOBER 17, 2024

Smith comment: before reading anything else, this case screamed pulmonary embolism to me. CT chest showed left sided pulmonary embolism and a pulmonary infarct that had previously been mistaken for pneumonia. There was 100% proximal LAD occlusion with TIMI 0 flow, and cardiac arrest in the cath lab. As per Dr.

Chest Pain 72

Chest Pain STEMI Pulmonary Embolism 72

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Clinically — despite an initial 2-fold increased troponin, the normal bedside Echo was reassuring against OMI or pulmonary embolism. This sinus tachycardia ( at ~130/minute ) — is consistent with the patient’s worsening clinical condition, with development of cardiogenic shock.

Cardiac Arrest 52

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

The morphology of V2-V4 is very specific in my experience for acute right heart strain (which has many potential etiologies, but none more common and important in EM than acute pulmonary embolism). He had multiple cardiac arrests with ROSC regained each time. CT angiogram showed extensive saddle pulmonary embolism.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52

All About Cardiovascular System and Disorders

OCTOBER 26, 2023

They include myocardial ischemia, acute pericarditis, pulmonary embolism, external compression due to mass over the right ventricular outflow tract region, and metabolic disorders like hyper or hypokalemia and hypercalcemia. These are the conditions which have to be considered or excluded as they can sometimes manifest Brugada pattern on ECG.

Sudden Cardiac Death 52

Sudden Cardiac Death Atrial Fibrillation Electrophysiology Arrhythmia 52