Emergency Care Today

ECG Cases 33 Brugada Syndrome: 3-Step Approach to Diagnosis and Management

Emergency Medicine Cases

JULY 19, 2022

Jesse McLaren guides us through 7 cases and explains his 3-step approach to diagnosing and managing Brugada syndrome in this month's ECG Cases blog. The post ECG Cases 33 Brugada Syndrome: 3-Step Approach to Diagnosis and Management appeared first on Emergency Medicine Cases.

EKG/ECG

EKG/ECG EMS

A young woman with chest pain, cath lab activated

Dr. Smith's ECG Blog

APRIL 6, 2024

She knew I was interested in ECGs, so she took a photo of this one. This was her presenting ECG: What do you think? This is clearly Brugada phenotype. And it is clearly Brugada phenotype. The conventional algorithm did not interpret Brugada. The conventional algorithm did not interpret Brugada.

EKG/ECG

EKG/ECG Hospitals

EM@3AM: Brugada Syndrome

EMDocs

SEPTEMBER 23, 2023

Answer : Brugada Syndrome Epidemiology and Etiology Rare genetic disorder that affects approximately 1 in 5,000 individuals worldwide 1. Clinical features Patients often present after an episode of sudden syncope, although Brugada syndrome can also be found on a routine EKG. ECG to evaluate for arrhythmia.

EMS

EMS EKG/ECG Documentation/Coding Emergency Department

A review of the utility of the ECG in Pediatric Syncope

PEMBlog

MAY 15, 2023

The majority of these are cardiac and so today we will review what to look for in your screening ECG. This is why ECG is recommended for all initial episodes of syncope with a reported sensitivity as high as 96%. Therefore, what are we looking for with our ECG? Concerning ECG findings Long QT syndrome: QTc longer than 480 msec.

Pediatrics

Pediatrics EKG/ECG Emergency Department Burns

What clinical scenario fits best?

Dr. Smith's ECG Blog

OCTOBER 12, 2023

B elow are 4 ECGs from the same patient. Accompanying the ECGs is some clinical information. Look at the ECGs and consider the timeline and other information. Which one do you think fits better with the ECGs and their timeline? As part of her work up in the ED an ECG was recorded. ECG#2 - day 4.

EKG/ECG

EKG/ECG Hospitals Sepsis Wellness

A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

JULY 22, 2023

An ECG was performed in the ED at 1554: Original image unavailable, this is the only recorded scanned ECG available. But there is also morphology potentially consistent with Brugada pattern/phenocopy, especially in V2. In a patient with syncope and fever, this ECG looks more like Brugada. What do you think?

EKG/ECG

EKG/ECG Hyperthermia / Hypothermia Documentation/Coding Wellness

What is this ECG finding? Do you understand it before you hear the clinical context?

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

Written by Pendell Meyers First try to interpret this ECG with no clinical context: The ECG shows an irregularly irregular rhythm, therefore almost certainly atrial fibrillation. Here is the initial ECG: A temperature sensing Foley was inserted and reported a core temperature of 26.7 C), with Cardiac Echo -- A Pathognomonic ECG.

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia EKG/ECG Wellness

Answers for ECG case for the 17th of January 2024

EMergucate

JANUARY 23, 2024

This ECG represents fever induced Brugada syndrome. Needs aggressive treatment of the fever and Cardiology referral for ICD. Additional information … Continue reading →

EKG/ECG

ECG Cases 46 ECG in Fever and Infectious Disease

Emergency Medicine Cases

OCTOBER 17, 2023

The post ECG Cases 46 ECG in Fever and Infectious Disease appeared first on Emergency Medicine Cases.

Infectious Diseases

Infectious Diseases EKG/ECG Sepsis EMS

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

As a routine part of his critical trauma evaluation, he had an ECG recorded: There is an rSR" in V1 and V2, with downsloping ST segment and inverted T-wave which is very similar to a Brugada Type 1 phenocopy. Moreover, this degree of ST Elevation is very unusual for Brugada. Is there also Brugada? Diagnosis: 1.

EKG/ECG

EKG/ECG Fractures Hyperthermia / Hypothermia Wellness

Another deadly and confusing ECG. Are you still one of the many people who will be fooled by this ECG, or do you recognize it instantly?

Dr. Smith's ECG Blog

MAY 5, 2022

Here is the initial ED ECG: What do you think? The ECG shows peaked T waves, QRS widening, a coved-type ST segment with inverted T waves most prominent in V1 and V2 consistent with Brugada pattern. They recommended repeating his ECG and awaiting troponin since the patient did not have any chest pain.

EKG/ECG

EKG/ECG Fluid Resuscitation EMS Shock

A Middle-Aged male with Chest Pain and an Unusual ECG

Dr. Smith's ECG Blog

MAY 6, 2019

This ECG was sent from South Asia. Here is the ECG: What do you think? Is it Brugada pattern? Followup ECG: No Change Absence of evolution is the best evidence against ischemia as the etiology. This is probably an unusual Brugada pattern. Answer : I don't know about the pain, but the ECG did not evolve at all.

EKG/ECG

EKG/ECG Hyperthermia / Hypothermia

A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?

Dr. Smith's ECG Blog

DECEMBER 5, 2019

As part of the workup, she underwent an ECG. V1 and V2 have type 1 Brugada pattern To determine whether it is indeed Brugada or not, it is important to determine whether the QRS is actually prolonged or not. However, if the QRS is not prolonged, then Brugada uncovered by fever is the likely culprit.

EKG/ECG

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding

Propofol-related Infusion Syndrome

Don't Forget the Bubbles

NOVEMBER 22, 2023

Propofol Infusion Syndrome (PRIS) can lead to significant morbidity and mortality in children. What is Propofol Infusion Syndrome (PRIS)? Propofol infusion syndrome in children. Propofol infusion syndrome: a structured literature review and analysis of published case reports. What is Propofol? Why does PRIS occur?

Pediatrics

Pediatrics Research EKG/ECG Operations

Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

JANUARY 30, 2019

The pattern of STE and STD reminded us of Brugada Type 1 morphology. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. It was from a patient with chest pain: Note the obvious Brugada pattern. See additional image at the bottom of this post. This patient ruled out for MI.

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia EKG/ECG Wellness Documentation/Coding

Saddleback ST Elevation. Is it STEMI? Is it type II Brugada?

Dr. Smith's ECG Blog

NOVEMBER 28, 2018

Here is his ECG: What do you think? V2 has the morphology of type II Brugada , as there is a relatively large beta angle , described here: Explanation 1. I put them in the correct position and we recorded another ECG: Now the P-wave in V2 is upright. Saddleback STE may be type II Brugada syndrome 3. QTc 388 ms.

EKG/ECG

Arrhythmias

EMergucate

MAY 11, 2016

Definition Conduction system Arrhythmia Mechanisms Causes Principles of management Management Options Vaughan-Williams Classification of antiarrhythmics Brugada Syndrome (See ECG Article … Continue reading →

EKG/ECG

EKG/ECG EMS

Cardiac Rhythms/ECG Module

Don't Forget the Bubbles

JULY 26, 2023

Add into this that the majority of children will be in normal sinus rhythm (NSR) by the time of assessment so to truly identify those who have something wrong we have to be confident in identifying arrhythmias where they are present and critical when analysing an ECG in NSR. All were examined and 98% had an ECG.

EKG/ECG

EKG/ECG Hospitals Shock Documentation/Coding

Unconscious + STEMI criteria: activate the cath lab?

Dr. Smith's ECG Blog

JANUARY 21, 2023

ECG met STEMI criteria and was labeled STEMI by computer interpretation. What is your ECG interpretation, and would you activate the cath lab? This ECG shows a sinus bradycardia with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, normal R-wave progression, normal voltages. What do you think?

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures

EM@3AM: Hyperthermia

EMDocs

DECEMBER 16, 2023

Neuroleptic malignant syndrome. The serotonin syndrome. Heat stroke, an unusual trigger of Brugada electrocardiogram. Temps greater than 41.5C per minute) 1,4 Body bag may be utilized if no immersion tank available 3 Evaporative cooling (DT 0.1C Temps greater than 41.5C Temps greater than 41.5C link] Velamoor V. link] Boyer, E.

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia EMS Stroke Seizures

Hypothermia at 18 Celsius in V Fib arrest: CPR, then ECMO rewarming, for 3 hours, then Defib with ROSC. Interpret the ECG.

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

A 12-lead ECG was recorded: There is sinus rhythm with RBBB and right axis deviation. Guide to this image: 30 minutes later, at 31 C, this ECG was recorded: The RBBB has resolved. Osborn waves persist The next day, this ECG was recorded at a normal temperature: Peak hs troponin I was 650 ng/L Day 1 echo ECMO flow 2.9

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia CPR EKG/ECG Resuscitation

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

What is your ECG interpretation and what would you do next? This ECG shows a normal sinus rhythm with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, late R wave progression (and misplaced V2), normal voltages, ST-elevation in aVR and global ST-depressions. BP was 110 and oxygen saturation was normal.

EKG/ECG

EKG/ECG Shock Sepsis Emergency Department

Compare these two ECGs. Do either, neither, or both show anything important?

Dr. Smith's ECG Blog

APRIL 17, 2023

Sean Rees MD, written by Pendell Meyers, other case by Sam Ghali and Steve Smith Take a look at these two ECGs below from two patients in the ED, first without any clinical context. The Queen of Hearts correctly says: Smith : Why is this ECG which manifests so much ST Elevation NOT a STEMI (even if it were a 60 year old with chest pain)?

EKG/ECG

EKG/ECG Documentation/Coding Emergency Department Psychiatric

Young Man with a Heart Rate of 257. What is it and how to manage?

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

WPW does not always have delta waves on the baseline ECG. y following initial presentation, including 13 patients with apparent pre-excitation on resting ECG. For clarity — I have put the 2 ECGs in today’s case together in Figure-1. Figure-1: The 2 ECGs in today’s case ( See text ). This is called "Concealed conduction".

EKG/ECG

EKG/ECG Psychiatric Wellness Resuscitation

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

APRIL 8, 2015

Abnormal ECG – looks for cardiac syncope. Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. If no previous ECG was available, ECG was classified as abnormal if any abnormality was present. orthostatic vitals b.

Emergency Department

Emergency Department EKG/ECG Outcomes Seizures

Emergency Care Today

ECG Cases 33 Brugada Syndrome: 3-Step Approach to Diagnosis and Management

A young woman with chest pain, cath lab activated

Trending Sources

EM@3AM: Brugada Syndrome

A review of the utility of the ECG in Pediatric Syncope

What clinical scenario fits best?

A man in his 70s with weakness and syncope

What is this ECG finding? Do you understand it before you hear the clinical context?

Answers for ECG case for the 17th of January 2024

ECG Cases 46 ECG in Fever and Infectious Disease

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

Another deadly and confusing ECG. Are you still one of the many people who will be fooled by this ECG, or do you recognize it instantly?

A Middle-Aged male with Chest Pain and an Unusual ECG

A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?

Propofol-related Infusion Syndrome

Hyperthermia and ST Elevation

Saddleback ST Elevation. Is it STEMI? Is it type II Brugada?

Arrhythmias

Cardiac Rhythms/ECG Module

Unconscious + STEMI criteria: activate the cath lab?

EM@3AM: Hyperthermia

Hypothermia at 18 Celsius in V Fib arrest: CPR, then ECMO rewarming, for 3 hours, then Defib with ROSC. Interpret the ECG.

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Compare these two ECGs. Do either, neither, or both show anything important?

Young Man with a Heart Rate of 257. What is it and how to manage?

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

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