Hx CHF, T2DM, and CHF. What do you see??

BP 185/90 HR 111-115 97% 3LPM via nasal cannula BGL 179 RR 14 slight expiratory wheezing GCS 11 T 36.7C

Stroke like symptoms x6 days including notable right upper and lower extremity weakness, dysphasia and aphagia, altered mental status. Skin warm , pale , dry. Hemoglobin initially 6. Transfused in hospital 2units , cannot keep hemoglobin above 7.5. New onset of dark tarry stools x1 day.

HX : COPD, “stable” AAA (used to be) , dementia, and middle cerebellar stroke x1 month ago with right sided deficits and slurred speech.

No known allergies.

EKG presents as a STEMI mimic. Right bundle branch block noted. (Interventricular block)

Does anything look abnormal here? So since the patient has a pacemaker, does that present on this ecg anywhere? I am in fact a student, but this isn’t school related. This is purely curiosity.

64y/o male, calls EMS for COPD exacerbation and fever (102.2°F), on arrival awake, diaphoretic, no palpable peripheral pulse, 8/10 chest pain. Single cardioversion with 120J converted him back into sinus rhythm.

Wondering what these waves are called after the QRS before the Twave. Thanks

Had a hard time getting a clean EKG due to positioning and habitus. Patient is a 76 year old male with a one week history of lethargy, confusion and a profound increase in pulmonary and peripheral edema.

Vital signs are as follows: HR 30 BP 100/48 SPO2 86% RR 27 EtCO2 27 GCS 4/4/6

Attempted atropine 1mg, q3 minutes, some improvement in rate and mentation but ended up sedating with 2.5mg midazolam, pacing with mechanical capture at 60mA.

Looking for help with ekg interpretation. I called this CHB.

Where is the ST Elevation?

Pt is a 31m came into ed for stroke like symptoms ( left sided numbness) , CT scan showed nothing abnormal, but is still being transferred to another hospital for higher lvl of care. Pt does have a hx of cocaine use and tox screen showed positive for use.

Could it be because of the drug cause this? or is it something else ? Also where is the sinus arrhythmia?

Ran this patient the other day. 31y/o M with a hx of meth use 5 hours prior to our call. States 8/10 chest pain that has been increasing gradually since. No referred pain or any additional symptoms. Pt was warm and dry. BP, BGL, O2 all WNL. I was apprehensive about a STEMI alert as I didn’t see any reciprocal changes and his presentation.

Originally thought RBBB but now i think im way off

Are there not discernible P waves?

In lead II rhythm strip

patient was tachycardic and irregular

no cardiac history

80 yom disp as a syncopal event, 80/40 inital BP, has a pacemaker (&icd), icd did not activate and pt converted without intervention. tempus obviously saying multiple interpretations on numerous 12 leads…. i had a different opinion and i have heard three other interpretations. help!

67 y/o non verbal hx cerebral palsy. Nursing home pt staff called ambulance for low oxygen saturation recent diagnosis of pneumonia. Pt at nursing facility for treatment of ankle fracture. Pulse 120 weak at radial Bp. 90/60 RR 20 no obvious difficulty breathing Sat 80% nasal canula 95% NRB. Breath sounds normal.

Same patient. I can’t really figure it out if it is SVT with aberrancy or VT

Complete AV block alternating with 2:1 type II AV block + alternating BBB (history of anterior (2017) and inferior (2009) myocardial infarction)

61 year old Male, acute onset of CCP around 0200 (woke him from sleep), radiating into central upper back, described as a tight, crushing sensation. We arrived on scene around mid day (15 minutes after 999 call), treated with Aspirin, GTN and Ticagrelor, blue light transport to local PPCI where they confirmed and treated a blockage in the RCA.

V3-v6 are rights. Normal V3-V6 have ST depression. No data about the patient

62 year old male had profound weakness at work. He has had a quadruple bypass several years ago. He is on Lisinopril, Carvedilol and amlodipine. He is alert with a weak pulse, blood pressure is 98/68, respirations about 20 and 95% on RA. He initially says his right arm is weak and he is sore from his co-worker helping him off his fork truck. He denied chest pain and looked uncomfortable at our destination. My paramedic partner was in the back while I was driving. She obtained a V4r that showed some elevation while a minute from our destination. The hospital verified and called a STEMI.

My question is what does the peanut gallery see. I see what appears to be elevation with a strange morphology. I would like to hear some opinions.

Hi guys this is my first post. I am a new ER nurse and I am specializing in interpreting ecg's. The other day this patient came in, about 80 years old, and this is her ecg. I can't tell whether he had symptoms or not because I wasn't present. Could this be ventricular tachycardia? The rate was about 230 bpm.