Category: Dr. Smith’s ECG Blog

Patient with Paced Rhythm in Severe Cardiomyopathy Presents with SOB due to Acute Decompensated Heart Failure

This is a middle-aged male with h/o with a history of heart failure with severely reduced ejection fraction due to dilated ischemic cardiomyopathy (EF 5-10%), probably with some component of non-ischemic cardiomyopathy, with h/o CABG, who is status post ICD placement (and previous appropriate shocks for VT) and biventricular pacer (“cardiac resynchronization therapy”), who is on amiodarone

Left Bundle Branch Block, Severe Chest pain, Previous Normal Angio. What is going on?

A middle-aged woman with idiopathic cardiomyopathy and biventricular failure, with previous EF of 15%, presented with sudden onset severe substernal chest pain.  She had LBBB with a wide QRS, and therefore was a candidate for biventricular pacer for cardiac resynchronization, but when they had inserted her pacemaker, they could not get the LV lead into place (technical

A young man with lightheadedness and bradycardia, and an impatient AV node.

A healthy 20 y.o. man presented with lightheadedness. The symptoms began about 2 weeks prior and were exertional. He stated that he plays on a college basketball team and he noticed over the previous 2 weeks that every time he exercised with the team he felt lightheaded. There was no actual history of syncope. He had had no associated chest pain, shortness