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VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care. Echocardiogram showed LVEF 66% with normal wall motion and normal diastolic function. Lesions less than 70% are generally considered to be non-flow limiting. Two subsequent troponins were down trending.

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Abstract 4143844: Multidisciplinary management of a pregnant patient with advanced systolic heart failure

Circulation

After discharge, she was scheduled for a 2-week postpartum visit including echocardiogram, EKG, and NT-proBNP.Discussion:Given the patient's acute decompensation and fluid overload, medical optimization was essential prior to delivery. Home medications including isosorbide dinitrate, metoprolol, and hydralazine were continued.

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Abstract 4148010: Evaluation of Echocardiography and Biomarkers for Prognostication of RV Failure in COVID-19 Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO)

Circulation

In this study, we report associations between echocardiographic findings and laboratory markers that portend RV failure in patients with ARDS secondary to COVID-19 infection on ECMO.Methods:A single-center study was conducted in the cardiovascular ICU of our institute.

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

Circulation

He was administered a therapeutic dose of low-molecular weight heparin and transferred to the ICU. 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.

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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

CASE CONTINUED She was admitted to the ICU. 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 LBBB, ventricular pacing, etc.)." J Am Coll Cardiol.

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A Child with Blunt Trauma

Dr. Smith's ECG Blog

Course : A CT of the head, neck, chest, abdomen and pelvis showed no other unanticipated injuries and she was admitted to the ICU. No further ECG, troponin, or echocardiogram was done because she was asymptomatic, and had a normal rhythm and rate. She was discharged to home feeling just fine.

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What Lies Beneath

EMS 12-Lead

A 65 y/o Female was admitted to the ICU for septic shock. The combination of prolonged QT and deep T wave inversion throughout the precordium is typical of Takotsubo syndrome, or Stress Cardiomyopathy – which can occur in the context of a physiologically distressed ICU patient, further compromising their hemodynamics.