Dr. Smith's ECG Blog

NOVEMBER 25, 2017

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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COPD EKG/ECG Wellness Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. An immediate 12-lead EKG was obtained: There is ST elevation in leads aVR and V1, with marked ST depression in I, II, III, aVF, V3-V6. What should be done?

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EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

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.

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EKG/ECG Ultrasounds Documentation/Coding COPD 40

Mind The Bleep

NOVEMBER 21, 2023

” Yes, I have seen clerking look like this and I can confirm, it does not go down well. Examples of examination findings you might find helpful to keep in mind (list not exhaustive): GCS 15/15- alert, orientated, looks comfortable, warm and well perfused, in obvious pain, looks pale and clammy etc.

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Documentation/Coding COPD EKG/ECG Wellness 52

Dr. Smith's ECG Blog

DECEMBER 13, 2023

This is the result for this ECG, from MDcalc.com : The most accurate cutpoint is 18.2. And she learned it well: She is not highly confident, but she does diagnose OMI. Here is a similar case from Pendell: This ECG was handed over at triage. A value above 18.2 (LAD A value above 19 is about 97% specific for LAD OMI.

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EKG/ECG COPD Wellness Outcomes 126

Dr. Smith's ECG Blog

JANUARY 5, 2020

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? Shah and Rubin studied the computer rhythm interpretation of 2160 12-lead ECGs, compared to 2 cardiologists [ 18 ]. noted computer over-interpretation (false positives) of AF in 9 to 19% of ECGs [ 19 ].

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EMDocs

APRIL 22, 2024

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. If RV pressure is extreme, it can exceed LV pressure causing paradoxical septal wall motion toward the LV as well.

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Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 90

ACEP Now

JUNE 14, 2024

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.

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Dr. Smith's ECG Blog

FEBRUARY 28, 2020

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.

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EKG/ECG COPD Documentation/Coding Shock 52

Dr. Smith's ECG Blog

MARCH 12, 2018

Written by Pendell Meyers, with edits from Steve Smith Let's consider this nearly pathognomonic ECG without the clinical context (because sometimes the clinical context will not be as easy as in this case). This ECG is diagnostic of hemodynamically significant acute right heart strain. She was discharged and did well.

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Taming the SRU

JANUARY 22, 2025

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.

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