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Sudden shock with a Nasty looking ECG. What is it?

Dr. Smith's ECG Blog

She was found by medics agitated, hypotensive, diaphoretic, and in shock. There were 2 prehospital ECGs: What do you think? When I was shown this ECG, I said it looks like such widespread ischemia that is might be a left main occlusion, or LM ischemia plus circumflex occlusion (high lateral and posterior OMI).

Shock 128
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ECG Blog #453 — Is this Wellens' Syndrome?

Ken Grauer, MD

The ECG in Figure-1 was obtained from a middle-aged man who presented with a 2 week history of progressively increasing CP ( C hest P ain ) with exertion. He had his most severe episode of CP the day before he was seen with this ECG. An initial Troponin drawn less than 1 hour after the ECG in Figure-1 was recorded was over 10,000.

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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 140
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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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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

Recommend obtaining multiple EKGs to aid in the diagnosis of cardiotoxic effects such as dysrhythmias or interval widening, even if not apparent immediately after the overdose. 1,2 Cardiovascular: Obtain an initial EKG to determine the patient’s baseline and repeat. 1,2 Consider lidocaine if sodium bicarbonate fails. 1 Class IA (e.g.,

Poisoning 108
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Why the sudden shock after a few days of malaise?

Dr. Smith's ECG Blog

She presented to an outside hospital after several days of malaise and feeling unwell. The VSR is what is causing the cardiogenic shock! Since serial ECGs are not available so either of the two patterns described above could be present (only serial ECG could differentiate). Heart rate was in the 80s.

Shock 110
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See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

Dr. Smith's ECG Blog

The ECG below was recorded about 20 minutes after he regained consciousness. ECG #1 The above ECG shows sinus rhythm at about 60 bpm. Figure A It now becomes apparent that there is ST segment depression in almost every lead of the ECG (V1-V6, I, II, aVL and aVF). In the initial ECG (ECG# 1) aVR had ST elevation.

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