Dr. Smith's ECG Blog
APRIL 15, 2020
Here is her ED ECG: Here is the ED physician's interpretation: IMPRESSION UNCERTAIN REGULAR RHYTHM, wide complex tachycardia, likely p-waves. LEFT BUNDLE BRANCH BLOCK [120+ ms QRS DURATION, 80+ ms Q/S IN V1/V2, 85+ ms R IN I/aVL/V5/V6] Comparison Summary: LBBB and tachycardia are new. This is clearly ventricular tachycardia.
Ken Grauer, MD
AUGUST 16, 2024
I see the following: There is sinus tachycardia ( upright P wave with fixed PR interval in lead II ) — at the rapid rate of ~130/minute. Sinus Tachycardia and RAD — as already noted above. PEARL # 2: In the absence of associated heart failure ( cardiogenic shock ) — sinus tachycardia is not a common finding in acute MI.
Dr. Smith's ECG Blog
AUGUST 3, 2018
In the evening, a middle-aged man complained of chest pain at the nursing home. Nurses found him with a BP of 50/30 and heart rate of 130 and called EMS. There is a narrow complex tachycardia at a rate of 130. He was awake, with a pulse of 130 and BP of 50/30. Fluids were started. The patient arrived alert but cool and clammy.
EMS 12-Lead
AUGUST 22, 2022
From afar, there is gross tachycardia, cadence irregularities, and narrow QRS complexes that may, or may not, be Sinus in origin; and finally – a cacophony of wide complexes that might very well be ventricular in origin. McLaren : We’ve answered the first question – Sinus Tachycardia with episodic runs of wide QRS (RBBB morphology) and PVC’s.
Dr. Smith's ECG Blog
NOVEMBER 30, 2019
Is it ventricular tachycardia (VT) due to hyperK or is it a supraventricular rhythm with hyperK? She had home health nurse visits, and a BMP was sent the next day (the day prior to admission, presumably after 120 mEq of KCl replacement -- if she was taking as directed). It would be difficult to get a nurse to give it faster!
EMS 12-Lead
JULY 24, 2023
David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (ret) @DidlakeDW Expert commentary and peer review by Dr. Steve Smith [link] @smithECGBlog A 57 y/o Female with PMHx HTN, HLD, DM, and current use of tobacco products, presented to the ED with chest discomfort. This results in Type I MI. Severe Hypoxia b. Advanced LVH c.
Dr. Smith's ECG Blog
FEBRUARY 2, 2017
Here is the ECG: Sinus tachycardia. During the resuscitation, I ordered 10 mEq KCl push, but the patient received 40 mEq of KCl, push (far more than recommended) The resident had ordered 40 mEq and that is what the nurses heard. This patient presented with severe DKA. What do you think? What else? Is 40 mEq too much?
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