Dr. Smith's ECG Blog

FEBRUARY 8, 2015

They had already cardioverted at 120 J, then 200 J, which resulted in the following: Ventricular Tachycardia They then cardioverted at 200 J which r esulted in the same narrow complex rhythm shown above, at 185 beats per minute. This would treat both SVT or sinus tachycardia. I suggested esmolol if the heart rate did not improve.

Tachycardia 52

Tachycardia Chest Pain Pharmacology Myocardial Infarction 52

Dr. Smith's ECG Blog

OCTOBER 25, 2022

We see a regular tachycardia with a narrow QRS complex and no evidence of OMI or subendocardial ischemia. The differential of a regular narrow QRS tachycardia is sinus tachycardia, SVT, and atrial flutter with regular conduction. Now the patient is in sinus tachycardia. Her initial EKG is below. Same as initial ECG.

Tachycardia 52

Tachycardia Atrial Flutter Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

MARCH 6, 2020

Here was his ED ECG: There is sinus tachycardia (rate about 114) with nonspecific ST-T abnormalities. An ECG was recorded: This shows a regular narrow complex tachycardia at a rate of about 160. See my quick review of atrial tachycardia below) The tachycardia spontaneously resolved. BP:143/99, Pulse 109, Temp 37.2 °C

Heart Failure 52

Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52

Dr. Smith's ECG Blog

DECEMBER 26, 2020

Tachycardia and ST Elevation. Likewise, in some cases of ischemia concealed by flutter waves, the ischemia can be seen despite the flutter waves, whereas in other cases the dysrhythmia must be terminated before the ischemia can be clearly distinguished. Tachycardia to this degree can cause ST segment changes in several ways.

Atrial Flutter 52

Atrial Flutter Ischemia STEMI Tachycardia 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

Here is his 12-lead: There is a wide complex tachycardia with a rate of 257, with RBBB and LPFB (right axis deviation) morphology. Read about Fascicular VT here: Idiopathic Ventricular Tachycardias for the EM Physician Case Continued He was completely stable, so adenosine was administered. See Learning point 1 below. Arch Intern Med.

Tachycardia 52

Tachycardia Heart Disease Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

JULY 22, 2012

Interpretation: There is sinus tachycardia, with right bundle branch block (RBBB). Blunt cardiac injury my result in : 1) Acute myocardial rupture with tamponade 2) Valve rupture (tricuspid, aortic, mitral) 3) Coronary thrombosis or dissection (and thus Acute MI) from direct coronary blunt injury 4) Dysrhythmias of all kinds.

Dysrhythmia 52

Dysrhythmia Biomarkers Echocardiogram Ultrasound 52

Dr. Smith's ECG Blog

MAY 27, 2012

Our electrophysiologist, Rehan Karim, states he has ablated AVNR"T" ("T" because it is not tachycardia) in a 90 year old, and that he has seen rate-related BBB at very slow rates. The second explanation (AIVR), whether as a reperfusion dysrhythmia or not, seems most likely.

Chest Pain 52

Chest Pain Ischemia Dysrhythmia STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

Is it ventricular tachycardia (VT) due to hyperK or is it a supraventricular rhythm with hyperK? Here are other posts on hyperK, large calcium doses for hyperK, and ventricular tachycardia in hyperK Weakness, prolonged PR interval, wide complex, ventricular tachycardia Very Wide and Very Fast, What is it? How would you treat?

Cardiac Arrest 52

Cardiac Arrest Tachycardia Nursing Ultrasound 52

Dr. Smith's ECG Blog

JANUARY 5, 2020

Multifocal Atrial Tachycardia 2. Atrial dysrhythmias, and atrial fi brillation in particular, are frequently misdiagnosed by computer algorithms and then by the physician who overreads them. The rhythm is indeed irregularly irregular, so atrial fibrillation must be considered. Sinus with multifocal PACs 3. Sinus with multifocal PVCs 4.

Atrial Fibrillation 52

Atrial Fibrillation Tachycardia Arrhythmia Pulmonary 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

Then there is loss of pulses with continued narrow complex on the monitor ("PEA arrest") Learning Points: Sudden witnessed Cardiac Arrest due to ACS is almost always due to dysrhythmia. Tachycardia is of course, quite common in patients following cardiac arrest.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

Otherwise vitals after intubation were only notable for tachycardia. An initial EKG was obtained: Computer read: sinus tachycardia, early acute anterior infarct. She was ventilated by bag-valve-mask by EMS on arrival and was quickly intubated with etomidate and succinylcholine. A rectal temperature was obtained which read 107.9

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: In a large randomized trial of dopamine vs. norepinephrine (11) for shock which was published after the above-mentioned recommendations, dopamine had more adverse events (especially severe dysrhythmias, and especially atrial fibrillation). Hypotension may of course be a result of a brady- or tachydysrhythmia.

Ischemia 52

Ischemia Cardiogenic Shock Aortic Stenosis 52

Dr. Smith's ECG Blog

APRIL 8, 2015

If the patient has Abnormal Vital Signs (fever, hypotension, tachycardia, or tachypnea, or hypoxemia), then these are the primary issue to address, as there is ongoing pathology which must be identified. Most physicians will automatically be worried about these symptoms. The tracings were considered abnormal in the following cases: 1.

Arrhythmia 52

Arrhythmia Outcomes Risk Factors Chest Pain 52