Chest Pain Dysrhythmia STEMI 
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. Is there STEMI? 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 ??
Dr. Smith's ECG Blog
MAY 27, 2012
A 90 yo with a history of orthostatic hypotension had a near syncopal event followed by chest pain. Chest pain was resolved upon arrival in the ED. In other words, after reperfusion therapy for STEMI, the appearance of AIVR is usually a good sign, meaning that the artery is reperfused. His previous ECG was normal.
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
APRIL 8, 2016
A late middle-aged man presented with one hour of chest pain. Here is his ED ECG: There is obvious infero-posterior STEMI. What are you worried about in addition to his STEMI? Could the dysrhythmias have been prevented? to greatly decrease risk (although in STEMI, the optimal level is about 4.0-4.5
Dr. Smith's ECG Blog
OCTOBER 10, 2022
Written by Pendell Meyers and Peter Brooks MD A man in his 30s with no known past medical history was reported to suddenly experience chest pain and shortness of breath at home in front of his family. Chest pain, SOB, Precordial T-wave inversions, and positive troponin. What is the Diagnosis? Now another, with ultrasound.
Dr. Smith's ECG Blog
JULY 31, 2018
It is equivalent to a transient STEMI. Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. As emphasized by Dr. Smith — the best way to demonstrate acute ischemia is by identifying d ynamic S T- T wave c hanges in association with change in the nature of chest pain.
Dr. Smith's ECG Blog
MARCH 2, 2019
Opinions vary widely on the K level at which a patient must be admitted on a monitor because of the risk of ventricular dysrhythmias. My rationale is that if the K is affecting the ECG, then it is affecting the electrical milieu and can result in serious dysrhythmias. Until some real data is available, my opinion is this: 1.
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