Dr. Smith's ECG Blog

DECEMBER 11, 2018

This patient with a history diabetes was found with a GCS of 4. If the clinical setting is “right” (ie, an acutely ill patient with a history of diabetes, or impaired mentation with Kussmaul respiration ) — and , the initial ECG suggests marked hyperkalemia — then acute DKA should be immediately considered.

Tachycardia 52

Tachycardia Diabetes Pacemaker Arrhythmia 52

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 He also endorses fatigue, upset stomach, frequent urination, increased thirst, and decreased apatite over the past 2 days.

Chest Pain 117

Chest Pain Ischemia Echocardiogram Myocardial Infarction 117

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

Stroke Journal

JANUARY 30, 2025

Propensity score-matched analysis (PSM) (1:1) was performed with matching for age, gender, race, BMI, hypertension, diabetes mellitus, chronic kidney disease, hemoglobin level, low-density lipid (LDL) level, left ventricular ejection fraction, and various drugs including ACEi, ARBi, ARNI, beta-blockers, and diuretics. years, with 49.27% men.

Outcomes 40

Outcomes Atrial Fibrillation Heart Failure Tachycardia 40

Circulation

NOVEMBER 11, 2024

Background:In diabetic ketoacidosis (DKA), cardiac complications such as QTc interval prolongation can pose a risk for ventricular tachycardia. Circulation, Volume 150, Issue Suppl_1 , Page A4143624-A4143624, November 12, 2024.

Pediatrics 40

Pediatrics Tachycardia Arrhythmia Diabetes 40

Dr. Smith's ECG Blog

MARCH 4, 2023

This one is far more specific, as it is combined with sinus tachycardia and some T-wave inversion in V1-V3. and tachycardia, 1.8. Finally , they found that S1Q3T3, precordial T-wave inversions V1-V4, and tachycardia were independent predictors of PE. This is a classic S1Q3T3. Most S1Q3T3 is not due to PE. incomplete RBBB 1.7

Chest Pain 52

Chest Pain Embolism Tachycardia Pulmonary 52

Circulation

NOVEMBER 11, 2024

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. Patient did not report any symptoms and was hemodynamically stable.

Bradycardia 40

Bradycardia Coronary Artery Disease Kidney Disease Outpatient 40

Dr. Smith's ECG Blog

MAY 1, 2023

edits by Meyers A woman in her 60s with a history of chronic atrial fibrillation on Eliquis, ESRD on hemodialysis, type-II diabetes mellitus, prior CVA, hypertension, and hyperlipidemia presented to the emergency department with multiple complaints after missing dialysis. Tachycardia and ST Elevation. Christmas Eve Special Gift!!

Atrial Flutter 52

Atrial Flutter Tachycardia Arrhythmia Blog 52

Dr. Smith's ECG Blog

JUNE 17, 2017

There is sinus tachycardia. The above is what I thought when I saw this, so I went to the chart and found this history: A type I diabetic aged approximately 35 years old presented with chest pain, nausea, vomiting and diffuse abdominal pain. I saw this as I was reading a large a stack of ECGs: What do you think? The QTc is 462 ms.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Stents 52

Dr. Smith's ECG Blog

OCTOBER 17, 2024

Past medical history included diabetes and hypertension. There is sinus tachycardia at ~100/minute. As often emphasized by Dr. Smith — sinus tachycardia is not a common finding with acute OMI unless something else is going on (ie, cardiogenic shock ). Vitals were normal. The initial ECG for Patient #2 also shows RBBB.

Chest Pain 72

Chest Pain STEMI Pulmonary Embolism 72

Cardiometabolic Health Congress

AUGUST 30, 2024

Cardiometabolic diseases, encompassing cardiovascular conditions and metabolic disorders like diabetes, are among the most widespread global health challenges. Arrhythmias : A leadless pacemaker-defibrillator system provides antitachycardia pacing for ventricular tachycardia in patients with subcutaneous ICDs.

Cardiac Rehabilitation 52

Cardiac Rehabilitation Heart Failure Quality of Life Aortic 52

Dr. Smith's ECG Blog

JULY 1, 2019

Case 2: sent by Dr. James Alva A man in his 50s with diabetes, hypertension, and hyperlipidemia presented to the ED with chest pain and shortness of breath off and on over the past three days, with associated vomiting. The rhythm is sinus tachycardia at ~105/minute. The rhythm is sinus tachycardia at ~115/minute.

Chest Pain 52

Chest Pain Ischemia STEMI Blog 52

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

EMS 12-Lead

MARCH 19, 2023

He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. Breath sounds were clear in all lung fields. No appreciable skin pallor. He reported to be a social drinker, but used tobacco products daily.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

Dr. Sanjay Gupta

AUGUST 31, 2022

POTS stands for postural orthostatic tachycardia syndrome. Let’s call it Postural Orthostatic Tachycardia Syndrome – that’s not really a diagnosis – it’s just a medical jargon filled term for what the patient has just told us. What is POTS? When you examine them, the heart rate can be found to be excessively fast.

POTS 40

POTS Quality of Life Tachycardia COVID-19 40

Frontiers in Cardiovascular Medicine

FEBRUARY 24, 2025

Hypertension and diabetes were the two most common risk factors identified. were male, with the average age of 56.313.5 The average time to present to the emergency room after symptom onset was 3.7 The majority of patients (67.9%) have been diagnosed with ST- Elevated Myocardial Infarction and were classified as Killip class I.

Hospital 98

Hospital Myocardial Infarction Chest Pain Electrocardiogram 98

Dr. Smith's ECG Blog

MARCH 2, 2019

Biphasic T-waves in a Middle-Aged Male with Vomiting Diabetic Ketoacidosis: is there hypokalemia? My L IST includes the following: i ) LVH with strain; ii ) Ischemia; iii ) Digoxin use; iv ) HypoKalemia and/or HypoMagnesemia; v ) Tachycardia; and , vi ) Any combination of i-thru-v. You probably think it is left main. No, hypokalemia.

Sickle Cell Disease 52

Sickle Cell Disease Ischemia Dysrhythmia Chest Pain 52

Dr. Smith's ECG Blog

SEPTEMBER 21, 2020

I was texted these ECGs by a recent residency graduate after they had all been recorded, along with the following clinical information: A 50-something with no cardiac history, but with h/o Diabetes, was doing physical work when he collapsed. MY Thoughts on ECG #1: The rhythm is sinus tachycardia at 105-110/minute.

STEMI 52

STEMI Hospital Blog Defibrillator 52

AMS Cardiology

NOVEMBER 21, 2024

Shoveling snow is particularly risky for people at high risk for heart disease – if they are overweight or obese; smoke or have a smoking history; have type 2 diabetes, high cholesterol or high blood pressure; or a history of heart attack.

Heart Attack 52

Heart Attack Heart attacks Heart Failure Blood Pressure 52

Heart BMJ

MAY 23, 2024

A healthy subset (n=3942) was used to establish reference values (excluding persons with beta-blockers, cardiovascular disease, hypertension, heart failure, anaemia, diabetes, sleep apnoea or chronic obstructive pulmonary disease). Methods A 24-hour ECG was registered in 5809 atrial fibrillation-free individuals, aged 50–65 years.

Atrial Fibrillation 52

Atrial Fibrillation Cardiovascular Disease Diabetes Hypertension 52

HeartRhythm

APRIL 30, 2024

In patients with DM sudden cardiac death (SCD) typically from ventricular tachycardia (VT) accounts for as much as 40% of mortality. Mechanisms underlying the genesis of VT in the DM heart remain poorly understood

Sudden Cardiac Death 40

Sudden Cardiac Death Tachycardia Diabetes 40

European Journal of Heart Failure

OCTOBER 11, 2023

Fibrosis presence, non-sustained ventricular tachycardia and diabetes mellitus were independently associated with MACE, whereas a family history of dilated cardiomyopathy was associated with lower incidence of MACE. Non-sustained ventricular tachycardia (hazard ratio [HR] 5.1, Over a median follow-up of 7.9 (5.5–10.0)

Cardiomyopathy 40

Cardiomyopathy Outcomes Tachycardia Diabetes 40

Dr. Smith's ECG Blog

OCTOBER 20, 2024

Written by Magnus Nossen The patient in today's case is a male in his 70s with hypertension and type II diabetes mellitus. His wife contacted the ambulance service after the patient experienced an episode of loss of consciousness. The syncope lasted about 2-3 minutes according to his wife.

Cardiogenic Shock 127

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 127

Journal of Cardiovascular Electrophysiology

DECEMBER 16, 2024

Methods The primary effectiveness endpoint (PEE) was 12-month freedom from documented atrial fibrillation/atrial flutter/atrial tachycardia plus freedom from acute procedural failure, nonstudy catheter failure, repeat ablation failure, direct current cardioversion (DCCV), and Class I/III antiarrhythmic drug (AAD) failure.

Atrial Fibrillation 40

Atrial Fibrillation Quality of Life Atrial Flutter Ablation 40

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

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Higher troponin correlated with more history of heart failure, diabetes, and hypertension, as well as higher D-dimer, and nearly all inflammatory markers. This sinus tachycardia ( at ~130/minute ) — is consistent with the patient’s worsening clinical condition, with development of cardiogenic shock. Median age was 66.4

Cardiac Arrest 52

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock 52

EMS 12-Lead

MAY 8, 2022

2] But there is also Sinus Tachycardia! In today’s case the patient is suffering from diabetic ketoacidosis, which facilitates hydrogen ion shift into the cells in exchange for potassium. This makes occlusive MI (in isolation) less likely and merits further investigation, as well as intensified ECG scrutiny – specifically, the T waves.

ACE Inhibitor 52

ACE Inhibitor Ischemia STEMI Physiology 52

Wellnest

JULY 19, 2023

However, recent studies have observed that people below 40 are also experiencing heart attacks due to high blood pressure, cholesterol, diabetes, smoking, obesity, a sedentary lifestyle, and social and mental stress. The abnormal heart rhythms can further lead to death because of ventricular tachycardia and ventricular fibrillation.

Heart Attack 52

Heart Attack Heart attacks Blood Pressure Myocardial Infarction 52