Remove Echocardiogram Remove Embolism Remove Ultrasound
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Torsade in a patient with left bundle branch block: is there a long QT? (And: Left Bundle Pacing).

Dr. Smith's ECG Blog

Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates. EKG with paced complexes shown below shows much narrower QRS complex and echocardiogram showed improved LV systolic function primarily due to improvement in LV dyssynchrony. (J

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Concerning EKG with a Non-obstructive angiogram. What happened?

Dr. Smith's ECG Blog

The commonest causes of MINOCA include: atherosclerotic causes such as plaque rupture or erosion with spontaneous thrombolysis, and non-atherosclerotic causes such as coronary vasospasm (sometimes called variant angina or Prinzmetal's angina), coronary embolism or thrombosis, possibly microvascular dysfunction.

Plaque 127
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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. This entire case is not consistent with takotsubo. It can only be seen by IVUS.

Plaque 52
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"Pericarditis" strikes again

Dr. Smith's ECG Blog

The next morning the patient went for his routine echocardiogram, where the operator noticed a dilated aortic root at 5.47 Patients with pulmonary embolism or aortic dissection who have normal variant ST elevation are at high risk of being diagnosed with pericarditis when what they have is far more serious!! Pericarditis?

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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

He was started on a heparin drip and CTA of the chest was ordered to rule out pulmonary embolism. Echocardiogram showed severe RV dilation with McConnell’s sign and an elevated RVSP. Electrocardiographic Differentiation Between Acute Pulmonary Embolism and Acute Coronary Syndromes on the Basis of Negative T Waves - ScienceDirect.

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Abstract 4140751: “A silent death: Right heart clot in transit” Acute sub-massive pulmonary embolism

Circulation

He was requiring supplemental oxygen and an initial bedside cardiac ultrasound was unremarkable. Despite his large clot burden, there was absence of obstructive shock.Transthoracic Echocardiogram and bilateral duplex venous ultrasound were obtained to evaluate for right heart strain and clot burden. Cardiology was consulted.

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Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

A bedside ultrasound should be done to assess volume and other etiologies of tachycardia, but if no cause of type 2 MI is found, the cath lab should be activated NOW. While awaiting transfer to the cath lab, STAT echocardiogram was performed and showed LVEF 30-35%, as well as anterior, inferior, and apical hypokinesis, and apical thrombus.