Remove Chest Pain Remove Diabetes Remove Tachycardia
article thumbnail

Two patients with chest pain and RBBB: do either have occlusion MI?

Dr. Smith's ECG Blog

Written by Jesse McLaren Two patients in their 70s presented to the ED with chest pain and RBBB. Patient 1 : a 75 year old called paramedics with one day of left shoulder pain which migrated to the central chest, which was worse with deep breaths. Past medical history included diabetes and hypertension.

article thumbnail

A 30-something with Chest pain and SOB

Dr. Smith's ECG Blog

This one is far more specific, as it is combined with sinus tachycardia and some T-wave inversion in V1-V3. and tachycardia, 1.8. Finally , they found that S1Q3T3, precordial T-wave inversions V1-V4, and tachycardia were independent predictors of PE. This is a classic S1Q3T3. Most S1Q3T3 is not due to PE. incomplete RBBB 1.7

article thumbnail

Why the sudden shock after a few days of malaise?

Dr. Smith's ECG Blog

Sinus tachycardia has many potential causes. This is especially true for the elderly patient with sinus tachycardia. What is the cause of the sudden tachycardia? She had a very elevated troponin T at 12,335 ng/L at the time of presentation. The patient in today’s case suddenly became tachycardic while sleeping.

article thumbnail

Infection and DKA, then sudden dyspnea while in the ED

Dr. Smith's ECG Blog

Pulse was 115, BP 140/65, and afebrile He was found to have cellulitis and to be in diabetic ketoacidosis, with bicarb of 14, pH of 2.27, glucose of 381, anion gap of 18, and lactate of 2.2 While in the ED, patient developed acute dyspnea while at rest, initially not associated with chest pain. There is widespread ST depression.

article thumbnail

The Computer and Overreading Cardiologist call this completely normal. Is it?

Dr. Smith's ECG Blog

A 56 year old male with a history of diabetes, dyslipidemia, hypertension, and coronary artery disease presented to the emergency department with sudden onset weakness, fatigue, lethargy, and confusion. On the second morning of his admission, he developed 10/10 chest pain and some diaphoresis after breakfast.

article thumbnail

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

His medical history includes hypertension, a decade-long battle with diabetes, ischemic heart disease, a coronary bypass graft surgery ten years ago, a diagnosis of congestive heart failure for the last five years, and a prior ICD implantation five years ago. There is some ST-segment elevation in DII, DIII, aVF, V4-6. What is the rhythm?

article thumbnail

Slightly Peaked T-waves. What is it?

Dr. Smith's ECG Blog

There is sinus tachycardia. The above is what I thought when I saw this, so I went to the chart and found this history: A type I diabetic aged approximately 35 years old presented with chest pain, nausea, vomiting and diffuse abdominal pain. I saw this as I was reading a large a stack of ECGs: What do you think?