Dr. Smith's ECG Blog

JUNE 11, 2023

The patient was admitted to the cardiology service with a plan for EP study, however the cardiologist during that visit thought that the ECG showed only LBBB, and thought that the patient's dysrhythmia was atrial fibrillation with LBBB, instead of atrial fibrillation with WPW. So he was simply discharged without EP study.

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Tachycardia Atrial Fibrillation Chest Pain Blood Pressure 94

Dr. Sanjay Gupta

FEBRUARY 1, 2023

Similarly, there have been case reports of patients who were taking beta blockers to control dangerous heart rhythm disturbances and when the beta blocker was abruptly stopped it led to precipitation of ventricular dysrhythmias and even in some cases death. This is termed as ‘Acute beta blocker withdrawal syndrome’.

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Blood Pressure Angina Quality of Life Heart Rhythm 52

Dr. Smith's ECG Blog

SEPTEMBER 27, 2023

Is it sinus or is it a supraventricular dysrhythmia? If rapid, that means that the depolarization is rapidly advancing and that it must be using conducting fibers (Purkinje fibers), and is therefore supraventricular.

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Tachycardia Chest Pain Academic Arrhythmia 132

Dr. Smith's ECG Blog

OCTOBER 25, 2022

But adenosine only lasts for seconds, and if the dysrhythmia recurs, then the adenosine is gone. Prevent the initiation of the dysrhythmia -- this can be done with a beta blocker by prenenting PACS 2. Smith: should we give adenosine again? Adenosine worked. It converted the rhythm. We need to do one or both of two things: 1.

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Tachycardia Atrial Flutter Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

DECEMBER 24, 2023

Flecainide : This is a potentially dangerous Na channel blocker which can cause ventricular dysrhythmias including ventricular fibrillation. It is possible that her disease has progressed to the point where she cannot be kept in sinus rhythm, but it is worth a try. She is already anti-coagulated, so that is not an issue.

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Atrial Flutter Blog Aortic Aortic valve 127

Dr. Smith's ECG Blog

DECEMBER 26, 2020

Likewise, in some cases of ischemia concealed by flutter waves, the ischemia can be seen despite the flutter waves, whereas in other cases the dysrhythmia must be terminated before the ischemia can be clearly distinguished. Even when flutter waves conceal true ST segment deviations, the cause and effect relationship may be unclear.

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Atrial Flutter Ischemia STEMI Tachycardia 52

Dr. Smith's ECG Blog

JULY 22, 2012

Blunt cardiac injury my result in : 1) Acute myocardial rupture with tamponade 2) Valve rupture (tricuspid, aortic, mitral) 3) Coronary thrombosis or dissection (and thus Acute MI) from direct coronary blunt injury 4) Dysrhythmias of all kinds. Localized bleeding from contusion could cause hemopericardium even without rupture.

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Dysrhythmia Biomarkers Echocardiogram Ultrasound 52

Dr. Smith's ECG Blog

JUNE 14, 2017

Accelerated idioventricular rhythm in newborns: a worrisome but benign entity with or without congenital heart disease Here are other examples of Accelerated Idioventricular Rhythm, Usually a Reperfusion "Dysrhythmia" I saw this on the computer. Most physicians, at first glance, get this wrong. What is it? What is the rhythm?

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Chest Pain Congenital Heart Disease Article Congenital 52

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

If you don't know what the dysrhythmia is, then try procainamide. Pads were placed with ultrasound guidance, so they were in the correct position. What to do now? If you believe it is SVT, then try adenosine. Procainamide is proven better and safer than amiodarone for VT ( Procamio randomized trial ) AND it also works for SVT.

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Tachycardia Cardiogenic Shock Angina Coronary Angiogram 139

Dr. Sanjay Gupta

DECEMBER 19, 2022

The heart is an electrical organ and occasionally the electrics can choose to malfunction and the patient may develop a heart rhythm disturbance or a dysrhythmia such as AF or SVT or VT. Cardiac CT is now widely available and to my mind the easiest way to know about the blood vessels of the heart. You can only diagnose it in retrospect.

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Heart Rhythm Plaque Heart Attack Heart attacks 40

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

I could find very little literature on the treatment of severe life-threatening hypokalemia. There is particularly little on how to treat when the K is less than 2, and/or in the presence of acute MI.

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Cardiac Arrest Tachycardia Nursing Ultrasound 52

Dr. Smith's ECG Blog

JULY 22, 2023

There were no dysrhythmias on cardiac monitor during observation. This discussion comes from this previous post: Hyperthermia and ST Elevation Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias. He was found to be influenza positive. Is there fever again?

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Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 77

Dr. Smith's ECG Blog

APRIL 15, 2020

Inferior MI results in scar tissue which is a likely source of a re-entrant ventricular dysrhythmia. Here is the post-cardioversion ECG: There is sinus with RBBB There are inferior Q-waves suggesting old inferior MI. This would be the likely source of the VT.

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Tachycardia Nursing Heart Disease Dysrhythmia 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

A 30-something was in the ED for some minor trauma when he was noted to have a fast heart rate. He acknowledged that he had palpitations. but only when asked. He had a history heavy alcohol use. Blood pressure was normal (109/83).

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Tachycardia Heart Disease Ablation Atrial Flutter 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

I also believe that we physicians and medics are eager to treat dysrhythmias, and we want to see them even when they are not there. Dilated pupils and hypertension are a strong clue to sympathetic overload, but don't forget anticholinergic syndromes, including tricyclics!

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Tachycardia Chest Pain Pharmacology Myocardial Infarction 52

Dr. Smith's ECG Blog

JULY 31, 2018

Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. (For those of you who are accustomed to the units of high sensitivity troponin (ng/L), this is equivalent to 20,956.00 Again, cath lab was not activated. What does this troponin level mean?

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SCAD Chest Pain Myocardial Infarction Ischemia 52

Dr. Smith's ECG Blog

MARCH 6, 2020

Here is one full text article on the topic from Clinical Cardiology 2008: Diagnostic Approach and Treatment Strategy in Tachycardia-induced Cardiomyopathy Atrial Tachycardia (AT): another SVT in the ED Rapid dysrhythmia from non-sinus focus above AV node.

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Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

The limb lead abnormalities appear to be part of the Brugada pattern, as described in this article: Inferior and Lateral Electrocardiographic RepolarizationAbnormalities in Brugada Syndrome Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias.

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

Then there is loss of pulses with continued narrow complex on the monitor ("PEA arrest") Learning Points: Sudden witnessed Cardiac Arrest due to ACS is almost always due to dysrhythmia.

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Cardiac Arrest Chest Pain Embolism Pulmonary 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: In a large randomized trial of dopamine vs. norepinephrine (11) for shock which was published after the above-mentioned recommendations, dopamine had more adverse events (especially severe dysrhythmias, and especially atrial fibrillation).

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Ischemia Cardiogenic Shock Aortic Stenosis 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Dysrhythmia, pacer), 4) valvular heart disease, 5) FHx sudden death, 6) volume depletion, 7) persistent abnormal vitals, 8) primary CNS event __ 3) Mendu ML et al. Yield of Diagnostic Tests in Evaluating Syncopal Episodes in Older Patients Arch Intern Med 2009 Jul 27; 169:1299-1305.

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Arrhythmia Risk Factors Outcomes Chest Pain 52