Annals of EMCase A 42-year-old man is conveyed to the ED via private vehicle with a 1-week history shortness of breath and bilateral leg swelling. Past medical history is negative; he takes no medications. He injects heroin, last 2 hours prior to arrival, and smokes tobacco. On exam, blood pressure is 112/73 mm Hg, pulse 125 bpm, [...]
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Case A 42-year-old man is conveyed to the ED via private vehicle with a 1-week history shortness of breath and bilateral leg swelling. Past medical history is negative; he takes no medications. He injects heroin, last 2 hours prior to arrival, and smokes tobacco. On exam, blood pressure is 112/73 mm Hg, pulse 125 bpm, [...]
Filed under: Tracings | 3 Comments »
HPI A 15 y.o. girl was transported by EMS to the ED. She had just experienced her second syncopal episode in 8 days. This morning while in the bathroom at her family’s home getting ready for school, she felt nauseous and then passed out. When she awoke, EMS was on the scene. She had had [...]
Filed under: Tracings | Tagged: syncope, ventricular dysrhythmia | Leave a Comment »
HPI A 15 y.o. girl was transported by EMS to the ED. She had just experienced her second syncopal episode in 8 days. This morning while in the bathroom at her family’s home getting ready for school, she felt nauseous and then passed out. When she awoke, EMS was on the scene. She had had [...]
Filed under: Tracings | 8 Comments »
Winners Allison Loynd Marjan Siadat Richard Gordon David Mishkin Brian Kern Case ECG Interpertation anterolateral wall STEMI ST-elevation in leads I, AVL and precordial leads V2-V6. Evolving Q waves are seen in several leads. There is, in addition, complete heart block (CHB). The atrial rate is 125 bpm, while the ventricles are beating at 52 [...]
Filed under: Tracings | Tagged: cardiovascular, chest pain, conduction disorder, coronary syndromes, myocardial infarction | Leave a Comment »
A 79-year-old Bangladeshi man arrived in the ED via private car. He describes having chest pain for 4 hours that is worse on the left side than the right. He speaks no English and it is impossible to immediately obtain a more detailed recent history. His past medical history includes Type 2 diabetes and a [...]
Filed under: Tracings | Tagged: cardiovascular, chest pain, conduction disorder, coronary syndromes, ischemic heart disease, myocardial infarction | 12 Comments »
Case ECG Interpretation The ECG shows tachycardia (rate just >100 bpm) with a wide QRS complex. A right bundle branch block pattern is present. There is a large upright QRS in AVR suggesting right axis deviation but examination of the other limb leads suggests axis is deviated to the left at near -90 degrees. There [...]
Filed under: Tracings | Tagged: chest pain, dyspnea, hypotension, shortness of breath, tachycardia, venous thromboembolism | Leave a Comment »
A 53-year-old woman presents to the ED resuscitation suite following cardiac arrest. At a local shelter she was reported to have been experiencing “flu-like” symptoms and shortness of breath. On EMS arrival she was hyperventilating; subsequently, she collapsed and was pulseless and apneic. EMS performed ACLS, defibriillating twice. The patient arrived at the ED in [...]
Filed under: Tracings | 6 Comments »
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