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ECG Blog #435 — Did Cath Show Acute Ischemia?

Ken Grauer, MD

The ECG in Figure-1 — was obtained from a middle-aged woman with positional tachycardia and diaphoresis with change of position from suprine to sitting. Although CP ( C hest P ain ) was not a prominent symptom — ACS ( A cute C oronary S yndrome ) was suspected from the chest lead T wave inversion seen on this ECG. WHY — or Why Not?

EKG/ECG 433
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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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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. If this EKG were handed to you to screen from triage without any clinical information, what would you think? Do you appreciate any dynamic changes compared to the patient’s prior EKG? What do you think? In fact, Kosuge et al.

EKG/ECG 138
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ECG Blog #388 — Why Does Lead V1 Look Funny?

Ken Grauer, MD

The ECG in Figure-1 was obtained from an 18-year old woman — who moments before been resuscitated from out-of-hospital cardiac arrest. How would YOU interpret her post-resuscitation ECG? Does this ECG in Figure-1 provide clue(s) to the etiology of this patient's cardiac arrest? QUESTIONS: In light of the above clinical history.

EKG/ECG 370
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Chest pain and new regional/reciprocal ECG changes compared to previous ECGs: code STEMI?

Dr. Smith's ECG Blog

Below is old and then new ECG (old on top; new below). Both ECGs have normal sinus rhythm, normal conduction and normal voltages. Because of the ECG changes in a patient with chest pain, and with inferolateral hypokinesis on POCUS, the cath lab was activated. What do you think? But do they represent acute coronary occlusion?

EKG/ECG 93
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How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Dr. Smith's ECG Blog

The first EKG is from 2:30 PM on the day of presentation to the ER. My eyes would bulge within a second of viewing this ECG. I texted this to our group "EKG Nerdz," asking "Do you think that anyone could miss this?" No repeat ECG was recorded. The EKG was not repeated until 7 AM the next morning, about 16 hours later.

EKG/ECG 113
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An elderly male with acute altered mental status and huge ST Elevation

Dr. Smith's ECG Blog

EKG on arrival to the ED is shown below: What do you think? The providers documented concern for ST elevation in the precordial and lateral leads as well as a concern for hyperkalemic T waves in the setting of succinylcholine administration. 2) There was no terminal QRS distortion on these ECGs. or basilar ischemia.

EKG/ECG 103