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ECG Cases 45 ECG in Weakness and Neurological Symptoms

ECG Cases

Jesse MacLaren guides us through 10 cases of patients who present with generalized weakness or acute neurologic symptoms and discusses how to look for ECG signs of dysrhythmias, electrolyte emergencies, acute coronary occlusion, and demand ischemia in patients with generalized weakness and in patients with neurologic symptoms, to consider predisposing (..)

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Torsade in a patient with left bundle branch block: is there a long QT? (And: Left Bundle Pacing).

Dr. Smith's ECG Blog

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.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

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). CT angiogram showed extensive saddle pulmonary embolism. He had multiple cardiac arrests with ROSC regained each time. This is a quiz.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Dysrhythmia, pacer), 4) valvular heart disease, 5) FHx sudden death, 6) volume depletion, 7) persistent abnormal vitals, 8) primary CNS event __ 3) Mendu ML et al. Serious outcomes included death, arrhythmia, myocardial infarction, structural heart disease, pulmonary embolism, and hemorrhage. Results : Presyncope constituted 0.5%

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Unresponsive and Acidotic: OMI? Acute, subacute, or reperfused? What is the rhythm? Why RV dysfunction? Can CT scan help?

Dr. Smith's ECG Blog

It did not show pulmonary embolism or intra-abdominal pathology, but it did show this: See the dark area at the bottom of the image? There was no pulmonary embolism. Cath lab had not yet been activated, so he was taken to CT for a head and chest/abdomen/pelvis angiogram to rule out other causes of cardiac arrest.