Tag Archives: SVT

The Trouble with Sinus Tachycardia

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  Sometimes recognizing sinus tachycardia can give us fits. What? Sinus tachycardia? One of the most basic rhythms? The discussion that follows will highlight some of the difficulties sinus tach can present at high rates. The pitfalls of using the generalized term "SVT" will also be discussed. This discussion is not meant to imply that […]

Snapshot Discussion: 32 year old Male–Chest Discomfort

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Here is the discussion for the Snapshot Case: 32 year old male–Chest Discomfort. Sorry for the delay. If you recall, we have a young patient, a 32 year old male, with a heart rate too rapid to count. He is alert and oriented, and has a good pressure (126/70). He has been in the following […]

Narrow complex tachycardias – Part III

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Documenting the heart’s response to adenosine Let’s look at some different cases where adenosine was used. Rather than give you all the details about the age, gender, chief complaint, and vital signs, I’m just going to show you the rhythm strips. Right now I’m only concerned with how the heart behaves during the administration adenosine. […]

Narrow complex tachycardias – Part II

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Here’s a call that was very well executed. The patient was a 35 year old Hispanic female; walk-in patient at a volunteer clinic. Through an interpreter it was learned that the patient was complaining of palpitations and slight chest discomfort. The onset was sudden. The medical history was significant for “arrhythmias”. No medications. Skin: warm […]

Narrow complex tachycardias – Part I

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I've come to dislike the term "SVT" (supraventricular tachycardia). In the first place, it's not an arrhythmia. It's an umbrella term that covers a group of arrhythmias which require the AV node for their maintenance. Most importantly, it includes sinus tachycardia! For some reason, this is a difficult concept for many clinicians to grasp, partly […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
David Baumrind
All that wiggles isn’t Wellens’
@Gary, by all means, nitpick all you like. I agree with your assessment, and the post has been modified. Thank you for the feedback!
2014-08-30 17:28:16
Gary Huntress
All that wiggles isn’t Wellens’
Not to nitpick but is this really a "slightly leftward axis"? I and AVF are both positive. I put it at about +20 degrees, not leftward.
2014-08-30 11:49:35
Handsome Robb
87 YOM COMPLAINING OF CHEST DISCOMFORT AND DYSPNEA
CHF. 12-lead shows a sinus Tachycardia in the 120s with PACs, besides the anterior leads there's diffuse ST depression, the STE in the anterior leads can be explained by the LBBB, axis is good as well. I wish they posted the EtCO2 waveform so we could see but I'm assuming it's non-obstructive. The elevated EtCO2…
2014-08-30 08:08:22
Christopher Watford
“Bad heartburn” – 82 y.o. female without chest pain.
Brooks, Firstly, thank you for the warm welcome to the club. Secondly, the Glasgow algorithm's only published sens/spec for AMI is 51.6%/97.6% respectively (Tuscon STEMI Database). I've not been able to find any other publications. The GE Marquette 12SL algorithm has been widely studied, but is much older, and ranges in sensitivity from 48% to…
2014-08-29 16:50:14
CB
57 Year Old Male–Chest Discomfort
Given what he was doing (paint fumes on ladder painting) I would first question if the pain is reproducable. Yes his ekg isn't normal but looks like old inferior MI. And he is hypertensive. 02 a must. Def. would give ASA. First would give morphine and see how his cp and bp are. If still…
2014-08-29 11:37:25

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