Remove Dysrhythmia Remove Hypertension Remove Pulmonary
article thumbnail

A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

See these publications for more information Overall, management for cardiac contusion is mostly supportive unless surgical complications develop, involving appropriate treatment of dysrhythmias and hemodynamic instability.

article thumbnail

A Relatively Narrow Complex Tachycardia at a Rate of 180.

Dr. Smith's ECG Blog

Dilated pupils and hypertension are a strong clue to sympathetic overload, but don't forget anticholinergic syndromes, including tricyclics! I also believe that we physicians and medics are eager to treat dysrhythmias, and we want to see them even when they are not there. In this case, it resulted in VT, which could be cardioverted.

article thumbnail

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.

article thumbnail

Atrial fibrillation? Multifocal Atrial Tachycardia? Don't look at computer read until AFTER you interpret!

Dr. Smith's ECG Blog

Atrial dysrhythmias, and atrial fi brillation in particular, are frequently misdiagnosed by computer algorithms and then by the physician who overreads them. The KEY to getting this patient better will doubtlessly include optimizing pulmonary function. Many arrhythmias will prove uninterpretable — IF only 1 or a few leads are used.

article thumbnail

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. The patient was transported to the CCU for further medical optimization where a pulmonary artery catheter was placed.