A 29-year-old male comes to your ED complaining of pressure-like left sided chest pain that started an hour after he smoked marijuana. He has never felt anything like this before. He has no medical problems, surgeries, medications, allergies, and has no family history of heart disease. He does not smoke cigarettes, 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’s Dr. Carmelli with today’s Morning Report! Dextrocardia and Situs Inversus Definitions Situs solitus: Normal position of organs/structures Situs inversus: Opposite or reverse of normal position of organs/structures Levocardia: Cardiac apex pointing to the left Dextrocardia: Cardiac apex pointing toward the right Cardiac displacement: A secondary shift of heart Read more…
The EKG is an integral diagnostic tool in EM let alone the whole of medicine. It is a rapid, reliable and cost-effective method to aid in the diagnosis of cardiac pathology including ischemic and arrhythmic events. So how did it come about? The 12 lead EKG was innovated via multiple Read more…
Thanks to Dr. Kopping for presenting today’s Morning Report! Digoxin Toxicity Digoxin falls under cardioactive steroids Fox glove, oleander, dried toad secretions Na/K ATPase inhibition Resting potential more positive, more likely to depolarize Increases inotropy by preventing Ca leaving cell via Na/Ca channel Increases automaticity Narrow therapeutic window Poisoning Read more…
By Baruch Berzon MD and Richard Sinert MD Case Presentation A 32 year-old male presents in August to EMS with complaints of “flutter in my chest” and light-headedness for an hour. The paramedics find a young man in mild distress who is Diaphoretic with a heart rate of 220 and Read more…
Thanks to Dr. Eli Brown for presenting today’s Morning Report! Acute Aortic Regurgitation AR: diastolic flow of blood from the aorta into the LV Epidemiology: prevalence in U.S ranges from 2-30%, but on 5-10% have severe disease overall prevalence < 1% in general population. Predisposed in: 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…
67 yo F with permanent atrial fibrillation. Why is her rhythm regular? Best answer by May 18th at noon is our winner!