Dr. Smith's ECG Blog

NOVEMBER 22, 2023

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 See this post: What do you think the echocardiogram shows in this case? He was treated for infection and DKA and admission to hospital was planned.

Chest Pain 117

Chest Pain Ischemia Echocardiogram Myocardial Infarction 117

Dr. Smith's ECG Blog

JANUARY 1, 2024

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. The initial troponin T level was measured at 30 ng/L. What is the rhythm?

Tachycardia 111

Tachycardia Blog Heart Failure Ischemia 111

Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

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. The conventional computer algorithm called “ sinus tachycardia, otherwise normal EKG ”. No ECG was ordered on Day #1.

Chest Pain 119

Chest Pain Blog Hospital Tachycardia 119

Circulation

NOVEMBER 11, 2024

Echocardiogram was unchanged from baseline. He was counseled to abstain from cannabis use.Conclusion:At low to moderate doses, cannabis can lead to a surge in sympathetic activity causing tachycardia and hypertension, while parasympathetic activity is predominant at higher doses, causing bradycardia and hypotension.

Bradycardia 40

Bradycardia Coronary Artery Disease Kidney Disease Outpatient 40

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Case submitted and written by Mazen El-Baba MD, with edits from Jesse McLaren and edits/comments by Smith and Grauer A 90-year old with a past medical history of atrial fibrillation, type-2 diabetes, hypertension, dyslipidemia, presented with acute onset chest/epigastric pain, nausea, and vomiting. BP was 110 and oxygen saturation was normal.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 15, 2024

A patient in their 40s with type 1 diabetes mellitus and hyperlipidemia presented to the emergency department with 5 days of “flu-like” illness. We can see enough to make out that the rhythm is sinus tachycardia. Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). Edits by Willy Frick.

Chest Pain 63

Chest Pain Blog Arrhythmia Critical Care 63