Chest Pain Dysrhythmia Tachycardia 
Dr. Smith's ECG Blog
MAY 25, 2024
An elderly dialysis patient presented with chest pain. Here is her ECG: Regular Wide Complex Tachycardia. Here is her ECG: Regular Wide Complex Tachycardia. Could it be atrial tachycardia with RBBB and LPFB aberrancy? Here it is: There is sinus with normal conduction, very different from her tachycardia.
Dr. Smith's ECG Blog
SEPTEMBER 27, 2023
This was written by Magnus Nossen, from Norway, with comments and additions by Smith A 50 something smoker with no previous medical hx contacted EMS due to acute onset chest pain. Upon EMS arrival the patient appeared acutely ill and complained of chest pain. Is it sinus or is it a supraventricular dysrhythmia?
Dr. Smith's ECG Blog
JUNE 11, 2023
Written by Bobby Nicholson MD and Pendell Meyers A man in his 30s presented to the ED for evaluation of chest pain and palpitations. The ECGs show a wide complex, irregularly irregular tachycardia. At this point, the patient had been symptomatic for almost 5 hours, appeared unwell with chest pain and diaphoresis.
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. Ken notes AV dissociation. What to do now?
Dr. Smith's ECG Blog
FEBRUARY 6, 2024
Chest trauma was suspected on initial exam. The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Gunshot wound to the chest with ST Elevation Would your radiologist make this diagnosis, or should you record an ECG in trauma? He was intubated for altered mental status.
Dr. Smith's ECG Blog
FEBRUARY 8, 2015
They had already cardioverted at 120 J, then 200 J, which resulted in the following: Ventricular Tachycardia They then cardioverted at 200 J which r esulted in the same narrow complex rhythm shown above, at 185 beats per minute. This would treat both SVT or sinus tachycardia. I suggested esmolol if the heart rate did not improve.
Dr. Smith's ECG Blog
APRIL 15, 2020
Here is her ED ECG: Here is the ED physician's interpretation: IMPRESSION UNCERTAIN REGULAR RHYTHM, wide complex tachycardia, likely p-waves. LEFT BUNDLE BRANCH BLOCK [120+ ms QRS DURATION, 80+ ms Q/S IN V1/V2, 85+ ms R IN I/aVL/V5/V6] Comparison Summary: LBBB and tachycardia are new. This is clearly ventricular tachycardia.
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