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ECG Blog #432 — "Should I Shock this Patient?"

Ken Grauer, MD

I was sent the ECG in Figure-1 — without the benefit of any history. Figure-1: I was sent this ECG without any history. MY Thoughts on Today’s CASE: As tempting as it might be to reach for the defibrillator on seeing the ECG shown in Figure-1 — My initial reaction was different. No shock was needed. Is this VT?

Shock 402
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ECG Blog #443 — A 40s Man with CP and Dyspnea

Ken Grauer, MD

The ECG in Figure-1 was obtained from a man in his 40s — who presented to the ED ( E mergency D epartment ) because of CP ( C hest P ain ) and shortness of breath. QUESTIONS: In view of the above history — How would YOU interpret the ECG in Figure-1 ? Based on the history and the patient's initial ECG — the cath lab was activated.

EKG/ECG 320
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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. If this EKG were handed to you to screen from triage without any clinical information, what would you think? Do you appreciate any dynamic changes compared to the patient’s prior EKG? What do you think? In fact, Kosuge et al.

EKG/ECG 138
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ECG Blog #400 — Is this a NSTEMI?

Ken Grauer, MD

The ECG in Figure-1 is from an older man with known coronary disease — who presents to the ED ( E mergency D epartment ) with new CP ( C hest P ain ) over the past several days. QUESTIONS: In view of this history — How would you interpret the ECG in Figure-1 ? Figure-1: The initial ECG in today's case. Troponin is pending.

EKG/ECG 252
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Young man with Gunshot wound to right chest with hemorrhagic shock, but bullet path not near heart

Dr. Smith's ECG Blog

A young man presented with a gunshot wound to the right chest, with hemo-pneumothorax and hemorrhagic shock. But he did get an EKG: What is this? Figure-1: The ECG sent to Ken Grauer ( showing some semblance of "group" beating ). He got a chest tube and intubation and massive transfusion and stabilized. Formal echo was normal.

Shock 116
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ACMT Toxicology Visual Pearl: Salt, not Shock

ALiEM

What agent would most likely be responsible for these ECG findings? This EKG shows a wide complex (QRS 240 msec), irregular rhythm with left bundle branch block morphology at a rate slower than expected (90 bpm) for a ventricular arrhythmia such as ventricular tachycardia. Cyclobenzaprine Digoxin Flecainide Sotalol Reveal the Answer 3.

Shock 73
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ECG Blog #386 — OMI or Something Else?

Ken Grauer, MD

The ECG in Figure-1 was obtained from a previously healthy middle-aged man — who while performing his regular exercise routine, developed "slight" chest discomfort and "palpitations". Surprisingly — he was hemodynamically stable with minimal discomfort at the time his initial ECG in Figure-1 was recorded. Could the patient have WPW?

EKG/ECG 195