Remove Dysrhythmia Remove Ischemia Remove Risk Factors
article thumbnail

An athletic 30-something woman with acute substernal chest pressure

Dr. Smith's ECG Blog

She had zero CAD risk factors. Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. It they are static, then they are not due to ischemia. This is better evidence for ischemia than any other data point. hours of substernal chest pressure.

SCAD 52
article thumbnail

STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

If there is polymorphic VT with a long QT on the baseline ECG, then generally we call that Torsades, but Non-Torsades Polymorphic VT can result from ischemia alone. Could the dysrhythmias have been prevented? Severe hypokalemia in the setting of STEMI or dysrhythmias is life-threatening and needs very rapid treatment.

STEMI 52
article thumbnail

A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

There were no dysrhythmias on cardiac monitor during observation. This discussion comes from this previous post: Hyperthermia and ST Elevation Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias. He was found to be influenza positive. Is there fever again?

article thumbnail

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

Dr. Smith's ECG Blog

Evidence of acute ischemia (may be subtle) vii. Until then, I consider any of these to be independent adverse risk factors. -- Finally, a dedicated syncope unit may improve evaluation and outcome (17). 2nd or 3rd degree AV blocks or sinus pause of at least 2 seconds iv. Left BBB vi. Pathologic Q-waves viii. LVH or RV d.