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ECG Blog #432 — "Should I Shock this Patient?"

Ken Grauer, MD

I was sent the ECG in Figure-1 — without the benefit of any history. Figure-1: I was sent this ECG without any history. MY Thoughts on Today’s CASE: As tempting as it might be to reach for the defibrillator on seeing the ECG shown in Figure-1 — My initial reaction was different. No shock was needed. Is this VT?

Shock 414
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ECG Blog #452 — Is this Wide QRS Rhythm VT?

Ken Grauer, MD

The patient whose ECG is shown in Figure-1 — presented with acute dyspnea and hypotension. Figure-1: The initial ECG in today's case. ( I have previously reviewed a number of cases of "Shark Fin" morphology ( Se e ECG Blog #364 — Blog #410 — Blog #265 — among others ). Figure-2: I've labeled the initial ECG in today's case.

EKG/ECG 282
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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 117
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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.

EKG/ECG 238
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ECG Blog #443 — A 40s Man with CP and Dyspnea

Ken Grauer, MD

The ECG in Figure-1 was obtained from a man in his 40s — who presented to the ED ( E mergency D epartment ) because of CP ( C hest P ain ) and shortness of breath. QUESTIONS: In view of the above history — How would YOU interpret the ECG in Figure-1 ? Based on the history and the patient's initial ECG — the cath lab was activated.

EKG/ECG 394
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ECG Blog #449 — Isorhythmic AV Dissociation?

Ken Grauer, MD

The ECG in Figure-1 — was obtained from a 45-year old man with diabetes, who was being treated for septic shock. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? Figure-1: The initial ECG in today's case. What is the rhythm? Why does QRS morphology in the long lead II rhythm strip change every-other-beat?

EKG/ECG 266
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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 137