Dr. Smith's ECG Blog

JANUARY 2, 2025

CT of the chest showed no pulmonary embolism but bibasilar infiltrates. Because she has cardiomyopathy and ventricular dysrhythmias, the pacer included an Implanted Cardioverter-Defibrillator (ICD) Echo 6 days later after CRT: Normal estimated left ventricular ejection fraction. She was intubated. No wall motion abnormality.

Tachycardia 115

Tachycardia Cardiomyopathy Blog Bradycardia 115

Dr. Smith's ECG Blog

MAY 19, 2020

She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). After good ECMO flow was established, she was successfully defibrillated. Here is a case of ECMO defibrillation with near shark fin that was due to proximal LAD occlusion. The K was normal.

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2024

Today's case reminds us of the intuitive logic that if a patient has a shockable arrest ( ie, VFib ) — and following successful defibrillation shows evidence of acute OMI ( even if STEMI criteria are not necessarily fulfilled ) — that such patients have much to gain from immediate cath with PCI. (

Cardiac Arrest 109

Cardiac Arrest STEMI Ischemia SCAD 109

MIBHS

OCTOBER 31, 2024

Chronic Pulmonary Disease Lung diseases like chronic obstructive pulmonary disease (COPD) can lead to pulmonary hypertension, which in turn can cause the right side of the heart to enlarge, a condition known as cor pulmonale. Implantable Cardioverter-Defibrillator (ICD) to help manage dangerous heart rhythms.

Blood Pressure 52

Blood Pressure Blood Clot Heart Valves Heart Rhythm 52

Circulation

NOVEMBER 11, 2024

Background:Epicardial patch defibrillators (EPDs) were commonly implanted in the 1990s for secondary prevention of sudden cardiac death. Despite empiric bronchial artery embolization, hemoptysis persisted. Circulation, Volume 150, Issue Suppl_1 , Page A4139677-A4139677, November 12, 2024.

Defibrillator 40

Defibrillator Cardiac Arrest Sudden Cardiac Death Coronary Angiogram 40

EMS 12-Lead

MARCH 30, 2024

The receiving staff suspects pulmonary embolism due to S1Q3T3 on the ECG and administers TPA. The patient did have massive pulmonary emboli, but he also had profound intraventricular and subarachnoid hemorrhages. On ED arrival ROSC is achieved. The patient was ultimately discharged with a poor neurologic outcome.

Cardiac Arrest 124

Cardiac Arrest Pacemaker Pulmonary Bradycardia 124

Dr. Smith's ECG Blog

OCTOBER 10, 2022

It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation. The morphology of V2-V4 is very specific in my experience for acute right heart strain (which has many potential etiologies, but none more common and important in EM than acute pulmonary embolism). CPR was initiated immediately.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52