Two (apparent wide complex) Rhythms in One Patient: First is at rate of 300, second at Rate of 180
A middle-aged patient with no known significant past medical history had sudden onset of palpitations, diaphoresis, dyspnea. This lasted…
Massive Excessively Discordant Anterior ST Elevation in a Paced Rhythm
This patient has a standard DDD pacer, with RV pacing (not biventricular pacing), severe chronic nonischemic cardiomyopathy with EF of 10%…
Intravenous Nitroglycerine in STEMI, with data: Avoid its use if giving tPA
If you are giving tPA to patients with STEMI, it is wise to avoid IV nitroglycerine. I am revisiting this topic because of a recent case…
Great Chart of Pediatric ECG Intervals: QRS, QTc, and PR. All Ages.
My friend and colleague Ben Orozco, emergency physician at HCMC, and toxicologist with the Hennepin Poison Center, put together this very…
A 50-something year old with typical chest pain
A middle age male presented with chest pain. Here is his ECG; there was no previous for comparison: QTc is 380 ms. There is 3 mm of STE…
One Hour Lecture: Supraventricular Tachycardias (including ED management of atrial fibrillation)
This is a lecture on ED diagnosis and management of supraventricular tachycardias: Sinus Tach Paroxysmal SVT Atrial Fibrillation Atrial…
Inferior ST Elevation. BP 250/140.
This 50-something patient with no previous CAD complained of havinng had chest pressure the day prior, but stated she was asymptomatic at the…
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 nitroglycerine…
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…
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…