Everything you need to know about ECGs in the Emergency Department
Hello again fellow Bloggers! Time for the monthly blogpost you have been waiting for, Rhythm Nation. Enjoy! 90 yo F w/ h/o HTN, HLD, DM, asthma, presenting with 3 hours of acute SOB and mid-sternal, non-radiating chest pain. V/S: BP: 191/99, HR: 76, RR: 40, O2 99% on Read more…
If you guessed Type 1 Brugada syndrome, then you are correct! Pathophysiology Brugada syndrome is a disease resulting from a mutation in the SCN5A gene, which encodes a myocardial voltage-gated sodium channel. It is inherited via an autosomal dominant pattern with incomplete penetrance. Roughly half of reported cases are familial, Read more…
Hello Bloggers! Here is this month’s Rhythm nation…enjoy! 76yo M w/ h/o HTN, presenting with a 2 day history of fever and myalgias, with associated chest pain, back pain, neck pain and leg pain. Pt denies SOB, no URI sx, no abd pain, no N/V/D. V/S: temp 100.5, BP Read more…
Congratulations to Itamar for the best answer and discussion with kudos to Dr. Ben Kaufman as well for the first answer! This is atrial fibrillation with Wolff-Parkinson-White Syndrome (WPW). Itamar gave a very good discussion of wide-complex tachycardias. In our patient, the differential is indeed narrowed down by the Read more…
31 yo M presents to your Emergency Department with palpitations and shortness of breath. His EKG is below: 1. What is the interpretation? Rate, rhythm, axis, intervals, etc…. 2. What is the emergent and subsequent treatment? Best answer by 8/21/15 at noon will be the winner!
Here is the EKG: The first interpretation would be to figure out the differential diagnosis for a regularly irregular rhythm in coupled beats. Without looking into more rare causes of coupled beats, the common causes includes atrial bigeminy, ventricular bigeminy, second degree AV block, and atrial flutter with variable conduction. Read more…
Hello Blog nation! Please enjoy this month’s EKG blog post! Also, seniors, please see below for a hint, just for you ;). Here is the case: 58 yo M with h/o mitral valve prolapse p/w acutely worsening palpitations, dyspnea on exertion & lightheadedness x 4 days. Palpitations previously occurred intermittently, Read more…
Congratulations Dr. Grundmann! The ECG shows T-wave inversions with prominent U-waves in leads V3-V6, and less prominent in leads II, II, aVF. The QT interval is also prolonged. All signs pointing towards hypokalemia. This patient’s potassium level of 2.3 mEq/L. With the patient’s history of weakness following exertion and his Read more…
On a sunny mid-afternoon day, a 31 year old male presents to the ED after falling down a flight of steps and complaining of LE weakness. Exam significant for LE strength 4/5 proximally and 5/5 distally. Pt had a carbohydrate loaded dinner the night before and ran a 5K the Read more…
Rhythm Nation May 2015 Answer Congratulations to Dr. Reza Roodsari! This is indeed a case of digoxin toxicity. Whenever you see “regularized a-fib,” that is, regular QRS intervals in a patient with permanent atrial fibrillation, think digoxin toxicity until proven otherwise. What happened to this patient? Due to high digoxin level, this Read more…