r/EKGs

Patient on Pacemaker for complete heart block came with heart failure symptoms

HX of CKD with dialysis, last dialyzed two days ago, states he does not miss. Denies any other history.

Presented 70%RA, HR150, 190/110, RR26. 5 episodes of vomiting in front of us, notably was not nauseated, no warning.

Rales globally.

Nitro, BiPap after the puking was controlled with phenergan and zofran.

Improved to 90's on the Bipap.

33M complaining of heart palpitations, no prior ecg, no family history. Does it look like s1q3t3? Not mine

My professor already kinda cooked me the first time I tried to interpret this strip. This is the help she gave me. It’s in the chapter on junctional rythm and I thought it was type 1 heart block but now I feel confused. The orange stickies are her notes to me

75M called for SOB x1 hour and best tightness that began after the sob. Upon arrival pt states SOB self resolved but he still has chest tightness. No cardiac hx and no hx of afib. Has COPD
no other pertinent
hx

Called to 60s male complaining of rapid onset chest pain while at rest approximately 30 minutes prior. Described as substernal pressure with radiation. Hx of MI and coronary stent. Prior to lead placement, vitals noted to be normotensive with tachycardia at 170 bpm. EKG 1 was obtained on scene and interpreted as SVT with LBBB. Converted to sinus tachycardia without aberrancy after 6mg adenosine following failed Modified Valsava. Post-conversion EKG obtained but not attached due to artifact; however, was noted for concerning anterior T waves. 3rd EKG immediately prior ED arrival is attached as EKG 2. Interpreted as sinus tachycardia with De Winter T waves in v2-v3.

I see an ongoing OMI but thought I would bring it to the group for discussion. Outcome in comments.

RBBB? STEMI

Patient (m, 75years old) after bolus Aspiration, claims to have heavy breathing and slight chest pain. "Just in case ecg " looks like this. ER doc suggests pulmonary embolism in addition.

Some nasty non clinical VTs we induced during mapping.
ATP failed both times leading to 360 sweet Jules