Dr. Smith's ECG Blog: Wide Complex Tachycardia: Lewis Leads Do Not Diffe...

Dr. Smith's ECG Blog: Wide Complex Tachycardia: Lewis Leads Do Not Diffe...: An 83 yo complained of palpitations and dizziness and presyncope.  He had a history of systolic heart failure with an EF of 40-45% and h/o ...

Dr. Smith's ECG Blog: Spontaneous Reperfusion and Re-occlusion - My Bad ...

Dr. Smith's ECG Blog: Spontaneous Reperfusion and Re-occlusion - My Bad ...: This is a case I had about a decade ago. This is a 51 year old who was playing cards with his friends when he started to have left hand n...

de winter wave& Wellens sign

 (wellens =subacute LAD occlusion (there are 2 types of wellen)

de winter=ACUTE LAD OCCLUSION may equal STEMI

 occures also in circumflex & diagonal

URGENT CATH

de Winter's T-waves really represent very tight subtotal occlusion of the LAD.  Complete occlusion results in ST Elevation.  Very tight stenosis results in subendocardial ischemia with diffuse ST depression and STE in aVR.  de Winter's is a point halfway between these two: a hybrid of STEMI and diffuse ST depression with STE in aVR.

Burgada S.

  5%of all sudden cardiac deaths

20%of sudden cardiac deaths without suructural abnormality

age around 40

mortality is 10% per year without ICD

NO RULE OF ANTIARRHYTHMICS

9:54

MI in pregnancy

 treat in conjunction with cardiologist and OB

Aspirin

PCI better than lytics

just little streptokinase or tPA can pass to fetus???

heparine is ok

STEMI vs Pericarditis

MI

• STD in any lead other than V1&aVR

• ST elevation in III > II

• Horozontal or convex ST elevation

• checkmark sign

• new Q waves