August 2014 - Dr. Smith’s ECG Blog

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9 Min Read

onAugust 28, 2014

9 Hours of Chest Pain and Deep Q-waves: Is it too late for Thrombolytics? (Time Window for Reperfusion; Acuteness on the ECG)

A 50 year old hypertensive presented with 9 hours of central crushing chest pain. BP was 250/120, and after placement on an IV…

2 Min Read

Steve Smith

onAugust 26, 2014

Left Bundle with Convex ST Segment: Where is the J-point?

On July 26, I posted a similar problem, but in that case, the huge ST elevation was proportional. Here is another case in which it may…

3 Min Read

Steve Smith

onAugust 23, 2014

A Very Fast Regular Narrow Complex, Followed by an Equally Fast Regular Wide Complex

This case was sent to me by for analysis by Scott Flannagan in Australia. I am by no means a rhythm master like Dr. K. Wang, but I think…

wide_complex_tachycardia

1 Min Read

Steve Smith

onAugust 20, 2014

Does this single lead show a wide complex tachycardia?

A woman in her 50’s had a v fib arrest and required defibrillation 10 times before resuscitation to an organized rhythm. Here was the…

2 Min Read

Steve Smith

onAugust 17, 2014

Middle Aged Male with Burning Chest Pain — Assess the Entire Clinical Scenario

A middle-aged male presented with “burning” mid chest pain, with radiation to bilateral shoulders (pain radiating to both shoulder is…

3 Min Read

Steve Smith

onAugust 16, 2014

A Very Wide Complex Tachycardia. What is the Rhythm? Use Lewis Leads!!

A patient with a history of severely reduced left ventricular function, renal insufficiency and atrial fibrillation presented with slight…

No Reflow

38 Min Read

Steve Smith

onAugust 9, 2014

Poor Microvascular Reperfusion (“No Reflow”): Best Diagnosed by ECG

A previously healthy woman about 50 years old with no previous medical history or coronary risk factors presented 30 minutes after the sudden…

1 Min Read

Steve Smith

onAugust 7, 2014

A Very Wide Complex

What do you think of this ECG from a critically ill patient? See Below I can only give minimal information in order to protect identity: this…

3 Min Read

Steve Smith

onAugust 6, 2014

Massive ST Elevation After V Fib Arrest, Discordant Bedside Echo Results

A woman in her 40’s was brought the ED (not by ambulance) for what is believed to be a seizure. She was reportedly very anxious…

left main

14 Min Read

Steve Smith

onAugust 2, 2014

ST Elevation in Lead aVR, with diffuse ST depression, does not represent left main occlusion

There are many publications stating that ST elevation in lead aVR, with diffuse ST depression elsewhere, is due to left main (LM) occlusion.…

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Dr. Smith's ECG Blog

Month: August 2014

9 Hours of Chest Pain and Deep Q-waves: Is it too late for Thrombolytics? (Time Window for Reperfusion; Acuteness on the ECG)

Left Bundle with Convex ST Segment: Where is the J-point?

A Very Fast Regular Narrow Complex, Followed by an Equally Fast Regular Wide Complex

Does this single lead show a wide complex tachycardia?

Middle Aged Male with Burning Chest Pain — Assess the Entire Clinical Scenario

A Very Wide Complex Tachycardia. What is the Rhythm? Use Lewis Leads!!

Poor Microvascular Reperfusion (“No Reflow”): Best Diagnosed by ECG

A Very Wide Complex

Massive ST Elevation After V Fib Arrest, Discordant Bedside Echo Results

ST Elevation in Lead aVR, with diffuse ST depression, does not represent left main occlusion