Dr. Smith's ECG Blog
DECEMBER 26, 2020
Is this inferor STEMI? Atrial Flutter with Inferior STEMI? Inferolateral ST elevation, vomiting, and elevated troponin The treating team did not identify the flutter waves and they became worried about possible "STEMI" (despite the unusual clinical scenario). The EM provider asked if the cardiologist thought it was a "STEMI."
Dr. Smith's ECG Blog
MAY 27, 2012
In other words, after reperfusion therapy for STEMI, the appearance of AIVR is usually a good sign, meaning that the artery is reperfused. The second explanation (AIVR), whether as a reperfusion dysrhythmia or not, seems most likely. In fact, there may be less than 1 mm of concordant ST depression in lead V3. But it is not conclusive.
Dr. Smith's ECG Blog
JUNE 14, 2017
Accelerated idioventricular rhythm in newborns: a worrisome but benign entity with or without congenital heart disease Here are other examples of Accelerated Idioventricular Rhythm, Usually a Reperfusion "Dysrhythmia" I saw this on the computer. Is there STEMI? Most physicians, at first glance, get this wrong. What is it?
Dr. Smith's ECG Blog
JUNE 20, 2020
The medics were worried about STEMI, as it meets STEMI criteria. He was admitted for monitoring, as his risk of a ventricular dysrhythmia as cause of the syncope is high ( very high due to HFrEF and ischemic cardiomyopathy ). The troponins are NOT consistent with STEMI (OMI), which typically has a troponin I of at least 5 ng/mL.
Dr. Smith's ECG Blog
FEBRUARY 2, 2017
So the real QT is shorter, but the computer does not mention the U-wave, and the U-wave is as important as the T-wave in predicting cardiac dysrhythmias. There is a very prominent U-wave and some of what may appear to be a QT interval is a QU interval. This is an extremely dangerous ECG. The K returned at 1.9 This is extremely low for DKA.
Dr. Smith's ECG Blog
MARCH 2, 2019
Opinions vary widely on the K level at which a patient must be admitted on a monitor because of the risk of ventricular dysrhythmias. My rationale is that if the K is affecting the ECG, then it is affecting the electrical milieu and can result in serious dysrhythmias. Until some real data is available, my opinion is this: 1.
Dr. Smith's ECG Blog
JULY 31, 2018
It is equivalent to a transient STEMI. Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. If you would not have activated the cath lab based on the first ECG, you really should strongly think about it now. Again, cath lab was not activated.
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