Dr. Smith's ECG Blog

JANUARY 1, 2013

A middle aged male with no h/o CAD presented with one week of crescendo exertional angina, and had chest pain at the time of the first ECG: Here is the patient's previous ECG: Here is the patient's presenting ED ECG: There is isolated ST depression in precordial leads, deeper in V2 - V4 than in V5 or V6. There is no ST elevation.

STEMI 52

STEMI Ischemia Chest Pain Myocardial Infarction 52

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

This strip was obtained: Apparent Wide Complex Tachycardia at a rate of 280 What do you think? Troponins 34>33>43, likely secondary to myocardial injury from tachycardia. Sinus tachycardia does not go this fast. A 60-something ow healthy male had syncope while on treadmill. What do you want to do?

Atrial Flutter 63

Atrial Flutter Exercise AFIB Tachycardia 63

Dr. Sanjay Gupta

AUGUST 31, 2022

POTS stands for postural orthostatic tachycardia syndrome. Let’s call it Postural Orthostatic Tachycardia Syndrome – that’s not really a diagnosis – it’s just a medical jargon filled term for what the patient has just told us. If we can therefore increase the circulating volume, then patients do feel better.

POTS 40

POTS Quality of Life Tachycardia COVID-19 40

Dr. Smith's ECG Blog

AUGUST 9, 2024

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. The patient continued having chest pain. Circulation Research , 56 (2), 184–194. Is there STEMI? What is the rhythm?

Chest Pain 106

Chest Pain Arrhythmia Myocardial Infarction STEMI 106

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. Circulation. Circulation 67, No. Circulation 1970;41:623-627 9. The paramedic’s initial impression of the patient was that he was critically ill.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

Dr. Smith's ECG Blog

AUGUST 10, 2023

Case submitted and written by Dr. Mazen El-Baba and Dr. Emily Austin, with edits from Jesse McLaren A 50 year-old patient presented to the Emergency Department with sudden onset chest pain that began 14-hours ago. The pain improved (6/10) but is persisting, which prompted him to visit the Emergency Department. What do you think?

Chest Pain 98

Chest Pain STEMI Ischemia Nursing 98

Dr. Smith's ECG Blog

JUNE 2, 2023

She denied chest pain and denied feeling any palpitations, even during her triage ECG: What do you think? She was awake, alert, well perfused, with normal mental status and overall unremarkable physical exam except for a regular tachycardia, possible rales at both bases, some mild RUQ abdominal tenderness.

Tachycardia 96

Tachycardia Cardiomyopathy Electrocardiogram Article 96

Dr. Smith's ECG Blog

JANUARY 23, 2024

There was no chest pain. Shortly after isoprenalin infusion was initiated, there were short runs of ventricular tachycardia. The physiologic reason for this — is thought to be the result of momentarily increased circulation from mechanical contraction arising from the "sandwiched in" QRS complex.

Tachycardia 106

Tachycardia Arrhythmia Heart Disease Sudden Cardiac Death 106

Dr. Smith's ECG Blog

MARCH 6, 2020

This middle-aged man with no cardiac history but with significant history of methamphetamin and alcohol use presented with chest pain and SOB, worsening over days, with orthopnea. Here was his ED ECG: There is sinus tachycardia (rate about 114) with nonspecific ST-T abnormalities. BP:143/99, Pulse 109, Temp 37.2 °C

Heart Failure 52

Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. Written By Magnus Nossen — with edits by Ken Grauer and Smith. The below ECG was recorded.

Arrhythmia 130

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 130

Dr. Smith's ECG Blog

APRIL 8, 2016

A late middle-aged man presented with one hour of chest pain. See here for management of Polymorphic Ventricular Tachycardia , which includes Torsades. mEq of K pushed fast and circulated theoretically would raise serum K immediately by 1.0 Most recent echo showed EF of 60%. He had recently had a NonSTEMI.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

Below are 6 anecdotal cases of true complete left main occlusion with no collateral circulation: 3 have STE in aVR 1 has no ST shift in aVR 2 have STD in aVR The ECG can have a variety of presentations in LM Occlusion. You'll see that there is collateral circulation from the RCA. This is her ECG: An obvious STEMI, but which artery?

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

Otherwise vitals after intubation were only notable for tachycardia. An initial EKG was obtained: Computer read: sinus tachycardia, early acute anterior infarct. It was from a patient with chest pain: Note the obvious Brugada pattern. Circulation, 117, 1890–1893. [3]: There is no further workup at this time.

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

Answer : you must treat the patient's underlying condition causing sinus tachycardia, and repeat the ECG at the lower heart rate. Optimal QT interval correction formula in sinus tachycardia for identifying cardiovacular and mortality risk: Findings from the Penn Atrial Fibrillation Free study. which is 0.6 So is it really prolonged?

Bradycardia 52

Bradycardia Article Atrial Fibrillation Chest Pain 52

Wellnest

JULY 19, 2023

When a person experiences a heart attack or myocardial infarction, they may feel chest pain and other symptoms in different parts of their body. This indicates that restoring normal blood circulation as quickly as possible will result in less damage. So, how do you recognize a heart attack? Perform rescue breaths twice.

Heart Attack 52

Heart Attack Heart attacks Blood Pressure Myocardial Infarction 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Circulation. Most physicians will automatically be worried about these symptoms.

Arrhythmia 52

Arrhythmia Outcomes Chest Pain Risk Factors 52

Dr. Smith's ECG Blog

MARCH 3, 2025

A 69 year old woman with a history of hypertension presented to the emergency department by EMS for evaluation of chest pain and shortness of breath. She awoke in the morning with sharp chest pain which worsened throughout the morning. As her pain worsened, so did her dyspnea. This was written by Hans Helseth.

Tachycardia 73

Tachycardia Pulmonary Chest Pain Stenosis 73

Dr. Smith's ECG Blog

APRIL 9, 2025

A middle-age woman with no previous cardiac history called 911 for chest pain. Return of spontaneous circulation (ROSC) was the primary outcome. This was her prehospital ECG: What do you think? There is sinus rhythm with RBBB and obvious LAD OMI (proximal LAD occlusion): hyperacute T-waves in I, aVL and minimal STE in V1, V2.

Defibrillator 62

Defibrillator Cardiac Arrest Myocardial Infarction STEMI 62

Dr. Smith's ECG Blog

MARCH 8, 2025

He had no chest pain, dyspnea, or any other anginal equivalent, and his vital signs were normal. Circulation Research , 114 (12), 18521866. Circulation , 92 (3), 657671. Circulation , 125 (3), 491496. Circulation , 145 (13), 10021019. Journal of Geriatric Cardiology , 19 (6). link] Bentzon, J. Virmani, R.,

Cardiomyopathy 74

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 74