Chest Pain Document Dysrhythmia 
Dr. Smith's ECG Blog
JUNE 14, 2017
There was apparently no syncope and he had no bony injuries, but he did complain of left sided chest pain. His chest was tender. A bedside cardiac ultrasound was normal. An ECG was recorded: Avinash was understandably confused by this ECG. He wrote: "ECG 1 - shows wide ???IVCD IVCD type rhythm ?? What is it? What is the rhythm?
Dr. Smith's ECG Blog
JULY 22, 2023
He denied chest pain or shortness of breath. In the clinical context of weakness and fever, without chest pain or shortness of breath, the likelihood of Brugada pattern is obviously much higher. There were no dysrhythmias on cardiac monitor during observation. See below for PM Cardio digitized version of this.
Dr. Smith's ECG Blog
SEPTEMBER 19, 2023
He had concurrent sharp substernal chest pain that resolved, but palpitations continued. Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest. If you don't know what the dysrhythmia is, then try procainamide. What to do now? So I would give procainamide.
Dr. Smith's ECG Blog
JANUARY 5, 2020
This 60-something with h/o COPD and HFrEF (EF 25%) presented with SOB and chest pain. See below how this has been documented. Atrial dysrhythmias, and atrial fi brillation in particular, are frequently misdiagnosed by computer algorithms and then by the physician who overreads them. Here is the ECG: What do you think?
Dr. Smith's ECG Blog
APRIL 8, 2016
A late middle-aged man presented with one hour of chest pain. Could the dysrhythmias have been prevented? Document in the patient's chart that rapid infusion is intentional in response to life-threatening hypokalemia." Most recent echo showed EF of 60%. He also had a history of chronic kidney disease, stage III.
Dr. Smith's ECG Blog
JANUARY 30, 2019
It was from a patient with chest pain: Note the obvious Brugada pattern. Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. The elevated troponin was attributed to either type 2 MI or to non-MI acute myocardial injury. There is no further workup at this time.
Dr. Smith's ECG Blog
APRIL 15, 2020
Inferior MI results in scar tissue which is a likely source of a re-entrant ventricular dysrhythmia. As always — it’s nice when we have “the Answer” , here in the form of an EP study documenting the absence of any SVT — with confirmation that the rhythm is VT. This would be the likely source of the VT.
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