Remove Ischemia Remove Outpatient Remove Pericarditis
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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. Hopefully a repeat echocardiogram will be performed outpatient. Chest trauma was suspected on initial exam. Here is his initial ECG around 1330: What do you think? 1900: RBBB and LAFB are almost fully resolved. ST depression.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

In terms of ischemia, there is both a signal of subendocardial ischemia (STD max in V5-V6 with reciprocal STE in aVR) AND a signal of transmural infarction of the inferior wall with Q wave and STE in lead III with reciprocal STD in I and aVL. The rhythm is atrial fibrillation. The QRS complex is within normal limits.

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Syncope, chest pain, and inferior ST Elevation with Reciprocal ST depression in aVL

Dr. Smith's ECG Blog

Doesn't this necessarily mean that he was having ischemia? But vasovagal syncope typically has a prodrome such that further evaluation of today's patient may be needed as an outpatient to better assess for the cause of his sudden syncope. What does the Queen of Hearts think? What does the Queen of Hearts think? "No She is very good.