Remove 2020 Remove COPD Remove EKG/ECG
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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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Proportionality is a major element in the ECG Diagnosis of OMI.

Dr. Smith's ECG Blog

This is the result for this ECG, from MDcalc.com : The most accurate cutpoint is 18.2. Here is a similar case from Pendell: This ECG was handed over at triage. That said — the ST-T wave in lead V2 looks to be small only if viewed in the context of its absolute height, as one of 12 leads in the initial ECG shown above in today's post.

EKG/ECG 116
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A 40-something woman with acute pulmonary edema -- see the Speckle Tracking echocardiogram.

Dr. Smith's ECG Blog

A 49 year old woman with h/o COPD only presented with sudden dyspnea. Prehospital Conventional algorithm interpretation: ANTERIOR INFARCT, STEMI Transformed ECG by PM Cardio: PM Cardio AI Bot interpretation: OMI with High Confidence What do you think? The ECG findings are focal to the anterior and high lateral wall.

EKG/ECG 52
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Regular Wide Complex Tachycardia. What to do?

Dr. Smith's ECG Blog

A patient in the ICU with significant underlying cardiac disease [HFrEF 30%, non-ischemic cardiomyopathy, LBBB s/p CRT-D (biventricular pacer), AVNRT s/p ablation a few yrs ago, hx sinus tachycardia while on max tolerated BB therapy] went into a regular wide-complex tachycardia after intubation for severe COPD exacerbation. What do you think?

EKG/ECG 75
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A woman in her 20s with syncope

Dr. Smith's ECG Blog

Given her reported chest pain, shortness of breath, and syncope, an ECG was quickly obtained: What do you think? The beat-to-beat variation in the QRS complexes (electrical alternans) is a classic ECG finding of a large pericardial effusion or pericardial tamponade. For clarity in Figure-1 — I've reproduced her initial ECG.

EKG/ECG 52
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VT? Or Supraventricular tachycardic rhythm with aberrancy?

Dr. Smith's ECG Blog

Here is a normal LBBB: In LBBB, monophasic wide R-waves should be limited to the lateral leads in left bundle branch block, as in this ECG. In that ECG above, there are monophasic R-waves starting in lead V2 all the way out to V6. But why does this EKG look nothing like left bundle branch block? Is this sinus tachycardia or VT?

EKG/ECG 138
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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. 10,11 Vid 1. SubX4 Asystole RV > LV.