Dr. Smith's ECG Blog
SEPTEMBER 7, 2020
Suspect an idiopathic form of VT when a younger adult without known coronary or structural heart disease develops a regular WCT ( W ide- C omplex T achycardia ) rhythm during exercise or other strenuous effort — and despite this, seems to tolerate the WCT rhythm surprisingly well.
Dr. Smith's ECG Blog
APRIL 15, 2020
Inferior MI results in scar tissue which is a likely source of a re-entrant ventricular dysrhythmia. In my experience — sinus tach rarely exceeds 170/minute in a non-exercising adult patient. Here is the post-cardioversion ECG: There is sinus with RBBB There are inferior Q-waves suggesting old inferior MI.
Dr. Smith's ECG Blog
SEPTEMBER 19, 2023
If you don't know what the dysrhythmia is, then try procainamide. The fact that the 50yo man in today's case has known coronary disease ( including exercise-induced angina over the previous 3 months ) — means that even before looking at his initial ECG — statistical odds that his regular WCT rhythm will be VT are at least 90%.
Dr. Smith's ECG Blog
DECEMBER 24, 2023
Flecainide : This is a potentially dangerous Na channel blocker which can cause ventricular dysrhythmias including ventricular fibrillation. Before continuing flecainide, he had me get on a treadmill at full dose and at full exercise (18 minutes) and measured the QRS to be certain that the QRS did not lengthen at all. Coincidence?).
Dr. Sanjay Gupta
DECEMBER 19, 2022
The problem with both these tests are that they study the heart at rest and sometimes abnormalities may be picked up only when the heart is stressed and therefore combining these modalities with a stress test can be even more helpful and by far the best form of stress is exercise. You can only diagnose it in retrospect.
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