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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 ).

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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. Outcome: 100% LAD Occlusion Here the Queen explains why: The dark blue tells us that she is looking especially at the QRS in V3 and the T-wave in V2 and V3. Here is a similar case from Pendell: This ECG was handed over at triage.

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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.

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Chest discomfort and a dilated right ventricle. What's going on?

Dr. Smith's ECG Blog

The following ECG was recorded. The presenting ECG shows SR with narrow QRS complexes. First troponin I returned 3174 ng/l, at which point a repeat ECG was ordered. Not much difference from 1st ECG. At this point an old ECG on file was found for comparison. Upon admission she had ongoing slight chest discomfort.

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A Brilliant Comment Makes the Study of the Week

Sensible Medicine

More pertinent to your recent This Week in Cardiology podcast , patients with monomorphic ventricular tachycardia and coronary disease often have a small troponin rise and ST segment changes on their initial post-cardioversion ECG (and have established coronary disease).

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What is lurking underneath this new right bundle branch block?

Dr. Smith's ECG Blog

Written by Pendell Meyers, edits by Smith: Case A 72 year old female with hypertension and COPD presented with sudden shortness of breath and chest pain. Here is her triage ECG (the baseline is not available but reportedly "normal"): What is your interpretation? There is sinus rhythm with PACs and PVCs. Learning Points: 1.

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A Comprehensive Guide to Surgical Clerking

Mind The Bleep

An ECG will also help with anaesthetic planning Bloods: CRP, U&E, FBC, LFTs, INR (if on warfarin), VBG (for lactate, pH and glucose), amylase Group and save: not all surgical procedures need group and saves- these are expensive and in many cases, unnecessary- check first!