Post by @FTeranmd Image from Jacob et al. Heart Rhythm. 2011 Jun;8(6):915-22 We’ve all had a patient who shows up at the ED with a pacemaker or implantable cardioverter-defibrillator (ICD) that may be malfunctioning. The patient didn…
85 yo M with PMHx of CHF, paroxysmal atrial fibrillation and dual chamber PPM placed for sick sinus syndrome, who presents with lightheadedness, confusion and progressive lethargy x 1 day. At arrival to the ED patient hypotensive 70/30, bra…
A 55M h/o HTN presents with 5 hours of palpitations that woke him from sleep. His complaint is that the sensation of his fast beating heart is uncomfortable. There is no chest pain, no SOB. There are no other associated symptoms. Vitals: HR…
Thirsty (for knowledge) Thursday Patient is 72 yo F wtih PMH of HTN, severe aortic stenosis presented to ED with dizziness and shortness of breath, progressively worse over the last 2 weeks, both symptoms worse with exertion. Patient…
All of us have placed central line before. You enter the vein under ultrasound. The wire threads easily, or maybe there is a little resistance, but the wire passes anyway. You dilate, place the catheter and suture it in place. You then o…
65 yo M PMH of HTN, CAD, CHF (EF <30%), AICD wheeled into the cardiac room saying that he is getting shocked every 30 seconds. Vitals: T 36 HR 45 BP 205/100 RR 30 O2 sat 100% RA. Pt is placed on a monitor, EKG done which shows atrial fib…
What is NUTTV1?
76 y M p/w chest pain after using cocaine. EKG is below. What medications should be avoided in this patient? This EKG demonstrates sinus bradycardia with ST elevation in leads II, III, aVf, v3, v4, v5 and v6, suggesting inferior wall MI. In…
55 Chinese woman, no PMH, no meds. P/w epigastric discomfort x 2 weeks, not responding to Pepcid Maalox. Presented to Elmhurst ED for worsening epigastric discomfort and generalized weakness. No fever/chill. + Mild dry cough. No chest p…
33 male-smoker, denies cocaine use or family history of sudden cardiac death, presents to the ED with dry cough, chills, myalgias x 1 week now complicated by one episode of syncope one-night prior without any chest pain, palpitations, SOB,…
Happy Turkey Day We’ve all seen the patient who comes in complaining of chest pain with a left bundle branch block pattern (LBBB). Many times we don’t have an old EKG to compare. Just as a review, a LBBB presents difficulty si…
Look familiar? This is the yesterday’s ECG taken from Sgarbossa et al. 1996. Is this a true LBBB?
68F with chest pain. No prior ECG. What is going on here?
Interesting couple of pearls today regarding adenosine boluses for treatment of SVT courtesy of Bryan Hayes (@PharmERToxGuy). Standard dose is 6mg followed by 12mg, except under certain circumstances: The ingestion of caffeine prior to an a…
A previously healthy young patient presents to the ED with sudden onset headache followed by progressive and profound altered mental status. You rush them to radiology for a head CT, which shows a large subarachnoid hemorrhage. Upon return…
