Excellent interpretation by Dr. Tepler! Exactly right, bradycardia and Osborn waves were concerning for a cold patient – in this case had moderate hypothermia. The Osborn wave (aka J wave) is seen in a variety of conditions. It can be a normal variant, but with the combination of bradycardia other Read more…
You are handed this ECG and immediately get up to go see this new patient … why? What are you worried about? Best answer by Friday 4/17/15 at noon is our winner!
Dr. Grock presents today’s Morning Report! Case: 32 F 18 wks by LMP presents with chest pain: sharp, non-exertional, 7/10, mildly decreased ET, bilat LE edema. VS HR 102, BP 130/74, RR 20, Temp 99.8 oral, O2sat 98% on RA. What are you worried about? PE? MI? Let’s start Read more…
Rhythm Nation March 2015 – Answer! Congratulations to VTACHomas for being first! Excellent discussion from JFreedman and Eschnitz. This is a complicated ECG! Let’s first look at the option of ventricular bigeminy. Ventricular bigeminy has recurring premature ventricular contractions (PVCs) after every atrial sinus beat. There is then a Read more…
Thanks to Dr. Kincade for today’s Morning Report! Wellens Syndrome Pattern of inverted or biphasic T waves in precordial leads that are specific for critical LAD stenosis Critical stenosis LAD High risk of anterior MI w/o medical tx: 75% pt advance to ant MI in avg 8.5 days Read more…
26 yo M pmh multiple episodes of syncope as child p/w anxiety symptoms for months. No meds or illicits. His father died at age 39. He has the following dysrhythmia: Questions: What is this rhythm? What is your ED care and dispo? Best answer by March 23 Read more…
Kudos go to Dr. Bryan Jarrett for an excellent interpretation! Much discussion was had over this ECG. There is an AV dissociation where the P waves march out. There is a slightly wide QRS, but not that wide. There is a small variability in the morphology of the Read more…
Thanks to Dr. Lewis for today’s Morning Report! Congestive Heart Failure: Acute Pulmonary Edema Goal: (1) Preload Reduction (2) Afterload Reduction (3) Inotropic Support Nitroglycerin short-acting, rapid onset systemic venous and arterial dilator – decreases MAP by reducing afterload and preload repeated SL nitro (0.4 mg) q3-5 Read more…
This is a tough one and congratulations to the thorough responders. This month’s winner – Dr. Nico Grundmann! To start, TCA ingestion is the most common cause of Na-channel toxicity that we see in ECGs – but this patient was not taking TCA’s. She ingested more than 4 grams of Read more…