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ECG Blog #366 — Diltiazem didn't work.

Ken Grauer, MD

The ECG and long lead II rhythm strip in Figure-1 — was obtained from a COVID positive patient with persistent tachycardia not responding to Diltiazem. Figure-1: The initial ECG — obtained from a patient with persistent tachycardia. ( To improve visualization — I've digitized the original ECG using PMcardio ).

EKG/ECG 195
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An elderly male with acute altered mental status and huge ST Elevation

Dr. Smith's ECG Blog

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. EKG on arrival to the ED is shown below: What do you think? ng/mL (consistent with prior baseline), and a repeat EKG was obtained 1 hour after the initial EKG. or basilar ischemia.

EKG/ECG 118
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Atrial fibrillation? Multifocal Atrial Tachycardia? Don't look at computer read until AFTER you interpret!

Dr. Smith's ECG Blog

This 60-something with h/o COPD and HFrEF (EF 25%) presented with SOB and chest pain. Here is the ECG: What do you think? IJC Heart and Vasculature 25(2019). Shah and Rubin studied the computer rhythm interpretation of 2160 12-lead ECGs, compared to 2 cardiologists [ 18 ]. Among, 2447 ECGs, Mant et al.

EKG/ECG 52
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Evaluating Chronic Obstructive Pulmonary Disease

ACEP Now

Chronic obstructive pulmonary disease (COPD) is a chronic disease of the lungs caused by inflammatory and structural changes of the small airways and parenchyma of the lungs that result in chronic airflow obstruction and gas trapping. In 2019, the global prevalence of COPD was estimated to be 10.3 Click to enlarge.

COPD 52
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POCUS findings of hemodynamically unstable PE with cardiac arrest

EMDocs

RV chamber size alone is not enough information to rule-in a PE as RV cavity enlargement can be visualized in other conditions such as pulmonary hypertension, RV infarct, COPD and cardiac arrest from multiple causes. During a short period of ROSC an ECG was performed. EKG RV strain. 2019 Oct-Dec;29(4):169-171.

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Are these Wellens' waves?

Dr. Smith's ECG Blog

An ECG was texted to me (Smith) without any clinical information: What did I say? This clinical information followed: "The patient had a COPD exacerbation with a prehospital SpO2 of 60%. This clinical information followed: "The patient had a COPD exacerbation with a prehospital SpO2 of 60%. This is NOT Wellens.

EKG/ECG 52
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Breath Easy: Navigating Asthma and COPD Exacerbations

Taming the SRU

COPD is characterized by episodes of exacerbations, which require prompt recognition and management due to their potential to escalate rapidly and cause significant morbidity and mortality. Epidemiology Globally, more than 300 million people are affected by COPD, marking it as the third leading cause of death worldwide.

COPD 79