Calcium Channel Overdose

For those who could not make it to VMR, we went over a truly sick calcium channel blocker overdose case. If not, here’s a quick rundown, and a link to the slides.   Briefly, the case was a 17-year-old female who reportedly overdosed on 60 m…

A Heart-Stopping EKG

You see this EKG for your elderly patient who has just been admitted to the CCU and your eyes open up wide. What is the rhythm(s) below? SPOILERS AHEAD If you thought to yourself “is this complete heart block with a junctional escape…

Pacemaker Problems

More than just what company makes it Written by Erena Weathers Pacemakers have their own code.  Position I: which chamber is pacedPosition II: where the pacemaker senses the intrinsic rhythmPosition III: response to sensing T = Sensed activ…

Pacemakers Review Pt. 2

Cardiac pacing as an intervention can be conceptualized as addressing problems in electrophysiological conduction and/or.  So, for example, if there is a disruption in the electrical continuity between the atrium and the ventricle, a pacer…

Pacemakers Review Pt. 1

The pursuit of mastery over cardiovascular emergencies demands a rough familiarity with implanted devices which includes why they get implanted in the first place (indications), how they work, how they malfunction, and how they affect the E…

SVT and Paranasal Etripamil

Have you had one of those resus shifts where everyone and their mother seems to be in an arrhythmia? Have some of them been older patients with SVT that just make you a little antsy about giving medications like adenosine multiple times aft…

The Sinai Troponin

What is Sinai’s troponin assay? Answer: ARCHITECT STAT Troponin-I A Global Task Force with involvement from the American Heart Association (AHA), American College of Cardiology Foundation (ACCF), European Society of Cardiology (ESC),…

M is for morphine

Remember MONA (morphine, oxygen, nitro, aspirin) from med school? Well, she may be just “A” now…. Over the years, all of these treatments (except for good old aspirin) have become somewhat controversial in the treatment of ACS. Let’s focus…

How Safe is Mechanical CPR?

Question – How safe is mechanical CPR compared to manual CPR? There are two devices used for mechanical CPR – the AutoPulse and LUCAS – neither of which has been demonstrated to show a survival benefit over manual CPR in r…

The Echo in ACS

Case – 70 year old male mhx of HTN, IDDM presents with 2 hours of exertional chest pain. His ECG in triage is unremarkable for any ischemic changes. He appears uncomfortable and over the next 30 minutes requires escalating doses of ni…

A Young Man Presents with Syncope

Case – 26M with no medical history presents with chest pain and palpitations. He states that he passed out while walking. He denies associated symptoms or family history of sudden cardiac death. ECG: Question – What are the ECG…

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