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ECG Blog #436 — Bigeminy or Alternans?

Ken Grauer, MD

Acute myocardial ischemia. Cardiac Sarcoidosis. Primary Cardiac Tumors and/or Cardiac Metastasis. Pleomorphic VT and Sudden Cardiac Death — Editorial by Liu and Josephson on potential mechanisms to explain the ECG appearance of Pleomorphic VT. CPVT ( Catecholaminergic PolyMorphic VT ).

Blog 160
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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

This was interpreted by the treating clinicians as not showing any evidence of ischemia. This is a critically important determination because of the 2017 AHA/ACC/HRS Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.

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Seizure in a 30 something

Dr. Smith's ECG Blog

The patient did not have a positive family history of epilepsy, sudden cardiac death (SCD) or recurrent syncope. The QT interval can be normal in patients with LQTS, and sometimes only manifests after a trigger such as hypokalemia or certain drugs. Learning Points: LQTS can have normal QTc.

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Brugada Syndrome: Diagnosis and Risk Stratification

All About Cardiovascular System and Disorders

Brugada syndrome is thought to account for about one fourth of sudden cardiac deaths in individuals with structurally normal heart. Even though mutations in other channels have been described in Brugada syndrome, only those in SCN5A gene are considered to be definitely disease causing. mV or R/q ≥ 0.75.

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What kind of AV block is this? And why does she develop Ventricular Tachycardia?

Dr. Smith's ECG Blog

Extensive conduction system abnormalities can have various causes (ischemia, genetic, infectious, amyloid, etc). The granulomatous inflammation affects the heart, causing an infiltrative cardiomyopathy The most common manifestations of cardiac sarcoidosis are atrioventricular (AV) block and ventricular tachyarrhythmias (VT).

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Dark Side of the Moon

EMS 12-Lead

When “spot diagnosing” precordial ST-depression I instinctively evaluate aVR for any corresponding ST-elevation to see if an emerging pattern of broad subendocardial ischemia can be appreciated, in which the ST-depression should be otherwise global and demonstrably maximal in Leads II and V5. He reported to EMS a medical history of GERD only.

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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

This discussion comes from this previous post: Hyperthermia and ST Elevation Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias. See more cases of Brugada due to fever here. Heart Rhythm, 15(9): 1394-1401. [7]