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ECG Changes in Intracranial Hemorrhage

All About Cardiovascular System and Disorders

ECG Changes in Intracranial Hemorrhage ECG changes are fairly common in intracranial hemorrhage. Giant T inversions with QT interval prolongation may be seen in intracranial hemorrhage even without associated myocardial damage [1]. But the number of persons with lobar hemorrhage in that study was only 17%. Am Heart J.

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A 50 year old man with sudden altered mental status and inferior STE. Would you give lytics? Yes, but not because of the ECG!

Dr. Smith's ECG Blog

Side note: The differential of sudden persistent loss of consciousness with adequate hemodynamics is relatively short: seizure, intracranial hemorrhage, basilar artery occlusion. We have also shown several cases in which atrial flutter hides true, active ischemia. Tachycardia and ST Elevation. Christmas Eve Special Gift!!

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Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

An Initial ECG was performed: Initial ECG: Sinus tachycardia with prolonged QT interval (QTc of 534 ms by Bazett). She was admitted to the ICU where subsequent ECGs were performed: ECG at 12 hours QTc prolongation, resolution of T wave alternans ECG at 24 hours Sinus tachycardia with normalized QTc interval. No ischemic ST changes.

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A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated. Sinus Tachycardia ( common in any trauma patient. ). He was intubated for altered mental status.

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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Anything more on history?

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Tachycardia must make you doubt an ACS or STEMI diagnosis; put it all in clinical context

Dr. Smith's ECG Blog

He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. He had this ECG recorded. Are the lungs clear?

STEMI 52
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Young Man with a Heart Rate of 257. What is it and how to manage?

Dr. Smith's ECG Blog

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.