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Hypertrophic Cardiomyopathy

EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review and commentary by Dr. Steve Smith [link] @SmithECGblog It is early-summer, approximately 1330 hours, no cloud cover overhead, and 86 degrees with high humidity. Are these findings consistent with a particular coronary distribution?

Coronary 130
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Formula Utilization

EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review provided by Dr. Steve Smith @SmithECGblog I was conducting QA/QI on two very recent cases and was struck by the uniqueness of both. It’s important to stress the presence of a normal QRS (i.e., This ECG immediately struck me as an LAD occlusion.

ACS 130
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Syncope and Block

EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review provided by Dr. Steve Smith [link] @SmithECGblog A 72 y/o Male experiences a syncopal episode while seated. Evaluation of T-wave morphology in patients with left bundle branch block and suspected acute coronary syndrome. 3] Meyers, H.

Coronary 130
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What Lies Beneath

EMS 12-Lead

The coronary angiogram revealed no critical stenosis, or acute plaque ulceration. Takotsubo should be a diagnosis of exclusion after angiography reveals no obstructive coronary disease, and repeat Echo displays left ventricular recovery. Furthermore, pertinent electrolyte values (e.g. potassium) were within normal parameter.

E-9-1-1 130
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Dark Side of the Moon

EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review by Dr. Stephen Smith @smithECGblog I was reviewing ECG’s in our LifeNet database and happened upon this one without any knowledge of clinical circumstances. Cardiology admitted him for observation with plans for next-day coronary angiogram.

STEMI 130
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Hyperkalemia

EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review provided by Dr. Steve Smith [link] @SmithECGBlog An adult female called 911 for chest discomfort and difficulty breathing. Cardiology was consulted, who advised to surveil a metabolic process as this did not strike them as acute coronary syndrome.

STEMI 130
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Target Acquired

EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Expert commentary provided by Dr. Ken Grauer CASE 1 An 82 y/o Male called 911 for sudden onset dizziness while at rest. 4] Baranchuk, A, et al. Upon arrival he was found alert and oriented, and without gross distress. Attached is the first ECG. 3] Smith, S.

ALS 130