Tag Archives: ECG

Found on the LIFENET 05/2011

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Found on the LIFENET. What is your impression of this ECG?   *** UPDATE *** Consider this recent case from Dr. Smith's ECG Blog. ST-elevation in aVR, with widespread ST-depression "ST elevation in aVR is often thought to represent left main occlusion. However, it really just signifies widespread and diffuse subendocardial ischemia which could be […]

82 year old male CC: Shortness of breath – Conclusion

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This is the conclusion to 82 year old male CC: Shortness of breath. Let's take another look at the 12-lead ECG. This ECG shows a severe bradycardia. We need to ask a couple of very important questions. Is the patient stable or unstable? The patient is unstable. In fact, the patient is periarrest. We cannot […]

82 year old male CC: Shortness of breath

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Here's an interesting and somewhat unusual case submitted by a faithful reader who wishes to remain anonymous. EMS is called to the residence of a 82 year old male complaining of shortness of breath and weakness. On arrival the patient is found slumped sideways in a chair. He is weak and in significant distress, repeating, […]

88 year old female CC: Chest pain

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Here’s a really interesting ECG submitted by my good friend David Hildebrandt. EMS is called to an assisted living facility for an 88 year old female who is weak and complaining of chest pain. The patient is found lying on her side in bed. She appears acutely ill and states she is nauseated. She is […]

49 year old male CC: Chest pain

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From the archives. EMS is called to the vacation residence of a 49 year old male complaining of chest pain. On arrival the patient is found sitting at the kitchen table. He appears anxious and acutely ill. Past medical history: Healthy Meds: None Allergies: NKDA Skin is cool, pale and diaphoretic. He confirms that he […]

74 year old female CC: Chest pain

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Is there anything else you’d like to know about this patient?

50 year old male CC: Chest pain

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Here’s a really interesting case submitted by “Anonymous from Ann Arbor, Michigan.” Wolverines! Sorry, Buckeyes. EMS is called to the residence of a 59 year old male with a chief complaint of chest pain. Past medical history: Dyslipidemia Meds: Zocor The patient was given 600 mg ASA by the spouse prior to EMS arrival. Onset: […]

85 year old female CC: Respiratory distress – Discussion

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This is the follow-up and discussion for 85 year old female CC: Respiratory distress. As usual, thank you for all the insightful comments! The case demonstrates some very important points not the least of which is that the differential diagnosis of shortness of breath can be difficult, even for emergency physicians who have access to […]

85 year old female CC: Respiratory distress

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EMS is called to a local nursing home for a 85 year old female with a chief complaint of respiratory distress. On arrival the patient is found lying in bed in obvious distress. Respirations are 40 and shallow with a prolonged expiratory phase and accessory muscle usage. Auscultation of the chest reveals a poor tidal […]

78 year old male CC: Dizziness – Conclusion

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There were so many great comments on this case, including some great discussion on classifying wide complex tachycardias!

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Michael
Rate Related VS. Primary ST-T Changes:
I just don't see adequate evidence for WPW. I would be confident administering this PT Cardizem at .25mg/kg based on his hemodynamic stability. I'd also like to know more about PT history, like does he have AFIB at baseline and, if so, what does he take for it. I would also ask about a history…
2014-09-21 12:06:31
Tony
59 year old male: chest pressure – Conclusion
Thank you Christopher. I am wondering if this particular patient is one of the minority where the LCx is the dominant artery supplying the Posterior and Inferior regions. I believe this to be the case in only about 15% of the population. Whereas approx. 80% are Right dominant.
2014-09-21 08:39:21
John
Rate Related VS. Primary ST-T Changes:
ECG is a rapid atrial fibrilation with ventricular rates approaching 300 beats per minute suggestive of WPW. Widespread ST segment depression is most likely rate related ischemia; elevation in aVR is not a reliable finding with a rapid heart rate point away from LMCA occlusion. Slow the rate before looking for ischemia, injury, or infract.…
2014-09-21 01:49:03
Sean V
Rate Related VS. Primary ST-T Changes:
Also forgot to mention decrease the FiO2, 3LPM is getting us a SpO2 of 98%, titrate down so we staying at or above 94%. No need to hyperoxygenate & create all those fun free radicals. I would also include using an EtCO2 nasal cannula, lets get another measure of our cardiac output.
2014-09-20 02:32:20
Sean V
Rate Related VS. Primary ST-T Changes:
Atrial Fibrillation w/ Rapid Ventricular Response. There appears to be possible Delta Waves, the most prominent being in aVL, also leads I, II, and V6. In the EMS 12-Lead there appears to be a fusion beat, 3rd in V2, slurred R-wave appears quite consistent with a Delta wave. I would consider WPW as the primary…
2014-09-20 02:28:16

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