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Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. T wave alternans is a harbinger of cardiac instability and TdP. (3) No ischemic ST changes.

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Brugada Syndrome: Diagnosis and Risk Stratification

All About Cardiovascular System and Disorders

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.

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A woman in her 20s with syncope

Dr. Smith's ECG Blog

The ECG shows sinus tachycardia, a narrow, low voltage QRS with alternating amplitudes, no peaked T waves, no QT prolongation, and some minimal ST elevation in II, III, and aVF (without significant reciprocal STD or T wave inversion in aVL). It is difficult to tell if there is collapse during diastole due to the patient’s tachycardia.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

He had multiple cardiac arrests with ROSC regained each time. Dyspnea, Chest pain, Tachypneic, Ill appearing: Bedside Cardiac Echo gives the Diagnosis 31 Year Old Male with RUQ Pain and a History of Pericarditis. Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism.

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Should we activate the cath lab? A Quiz on 5 Cases.

Dr. Smith's ECG Blog

Smith: This bizarre ECG looks like a post cardiac arrest ECG with probable acidosis or hyperkalemia in addition to OMI. Bottom Line: Tests other than cardiac cath may be all that are needed to establish the diagnosis — but, I'd want to see a patient with this ECG as soon as would be possible. What was the pH and K?

Ischemia 112
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Unconscious + STEMI criteria: activate the cath lab?

Dr. Smith's ECG Blog

The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy. Prominent J waves and ventricular fibrillation caused by myocarditis and pericarditis after BNT162b2 mRNA COVID-19 vaccination. The final letter in the SLOWED mnemonic is " D " for "Dead" ( resulting from VT/VF or asystolic cardiac arrest ).

STEMI 52
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Cardiologist declines taking patient to the cath lab. Patient dies.

Dr. Smith's ECG Blog

Other than tachycardia, Other than slight tachycardia, vitals were within normal limits (including oxygen saturation). As always, takotsubo cardiomyopathy and focal pericarditis can mimic OMI, but takotsubo almost never mimics posterior MI, and both are diagnoses of exclusion after a negative cath. The PR interval is normal.