Dr. Smith's ECG Blog

NOVEMBER 19, 2016

DISCUSSION: The 12-lead EKG EMS initially obtained for this patient showed severe ischemia, with profound "infero-lateral" ST depression and reciprocal ST elevation in lead aVR. The ECG cannot diagnose the etiology of ischemia; it only the presence of ischemia, from whatever etiology.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

Dr. Smith's ECG Blog

OCTOBER 23, 2023

She had an uneventful ICU course and was extubated for ongoing care with the inpatient psychiatric service. Alternation in ST segment appearance ( or in the amount of ST elevation or depression ) — is often linked to ischemia. Teaching Points: 1. Repolarization Alternans — entails beat-to-beat variation in the ST segment and/or T wave.

Tachycardia 128

Tachycardia Cardiac Arrest ICU Blood Pressure 128

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

Normally, concavity in ST segments suggests absence of anterior ischemia (though concavity by itself is not reassuring - see this study ). His inpatient clinicians did not think that an urgent angiogram was warranted given that he was chest pain free, his EKG appeared nondiagnostic, and serial troponins were not elevating beyond 2 ug/L.

Chest Pain 52

Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

EMS 12-Lead

JUNE 1, 2022

Such findings would normally suggest primary ischemia with concomitant surveillance of coronary occlusion, but these ST/T changes might very well be secondary to the Escape mechanism at hand. The patient care narrative states no further changes in heart rate with persistent LBBB morphology. Hospital transport was unremarkable.

Heart Failure 52

Heart Failure Myocardial Infarction Bradycardia Chest Pain 52