Diastology

It’s not just about the squeeze. You gotta think about the filling. Yes, today we’re talking about diastology (I didn’t make that word up) AKA diastolic heart failure AKA heart failure with preserved ejection fraction AKA…

Pressors

The use of vasopressors and inotropes to treat hypotension is common in the emergency department.  It is now standard to start off with norepinephrine as your 1st line agent to treat shock in the ED.  But is norepi always that best choice?…

Cardiac Tamponade

Cardiac tamponade is a condition in which there is life threatening compression of the heart as a result of external pressure from the presence of fluid, gas, pus, clots, or blood in the pericardial space.

Doc, I’m Feeling Lightheaded…

A 43-year-old patient arrives to the ED complaining of palpitations. Vitals are HR 298, BP 107/74, SpO2 100% RA, RR 18. The patient is diaphoretic, uncomfortable appearing, and heart sounds are fast and irregular. You obtain an EKG which sh…

More Power

59 y/o M presents to the cardiac room after cardiac arrest. EMS reports a downtime of 5 minutes with immediate bystander CPR. The initial rhythm was vifb that responded to two EMS shocks and CPR. The patient arrived with ROSC. Soon after th…

Kidney Pains

53 y/o M PMD ESRD on dialysis presents with mild chest pain, now resolved. His EKG is unremarkable and trop is mildly elevated. There are no signs of overt heart failure. You call his cardiologist who tells you he has a “chronic troponin le…

Slow and Steady….

75 y/o M with a past medical history of atrial fibrillation presents to the ED not feeling well for several days. He has some diarrhea but has continued to take his medications. He is mildly hypotensive. While IV access is established, you…

Wide-complex, Irregular Tachycardia

You are catching up on some charts in the resuscitation area of your ED when your triage nurse pushes in a 37 yo M with no PMHX, who presented to your ED complaining of sudden onset lightheadedness and L sided chest pain about 10 minutes PT…

Yet Another Scary Ekg Finding…

@JoePinero As if there weren’t enough morphologies and subtleties in the EKG, here is another ekg finding that you should be aware of… de Winter T-waves 1-3 mm ST-depression upsloping at the J-point in the mid precordial leads l…

Cardiology Board Questions

1. Which of the following is the earliest EKG finding in acute MI? A. hyperacute T waves B. ST elevation C. ST depression D. T wave inversion E. Q wave 2. Which of the followingis true regarding pediatric EKG analysis? (A) Left axis deviati…

May 2024
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