Rhythm Nation August 2014 Answer! Best and most thorough and most correct reading goes to… Dr. Freedman! The major clue to this case is the recent or evolving STEMI. In the era of thrombolysis for STEMI, the Accelerated Idioventricular Rhythm (AIVR) or Accelerated Ventricular Rhythm was often seen after reperfusion. Read more…
70 yo M with pmh DM and HTN presents with chest pain and a troponin of 41. STEMI code activated and patient taken to cath lab. Here is his EKG upon arrival: 1. What is this rhythm? 2. What is the treatment for this rhythm? Answers were due 8/15/2014… now you Read more…
Thanks to Dr. Freedman for today’s Morning Report! Digoxin Toxicity Background: Naturally occurring chemical compounds Na+/ATPase Channel blockers Prone to poisoning Large volume of distribution Long half-life, ~36 hours Narrow therapeutic window, 0.6 – 1.3 ng/mL Digoxin: An Old Drug: CHF, A fib ~2% of all international patients. One Read more…
Congratulations to our winner with the most complete answer: Dan Zeccola! Julie and Nathan both correctly identified parts of the answer. Well done all! Our patient was having a Spontaneous Coronary Artery Dissection (SCAD) in her mid-LAD. To answer the questions: The EKG was concerning for Wellens’ Sign and in Read more…
Here’s Dr. Grock with today’s Morning Report! The Case: 65 yo F known CHF presents with palpitations. Compliant with home meds, except Coumadin. No chest pain/sob/change in ET/orthopnea/pnd/other complaints. EKG shows: afib, rate of 87. CBC/CMP/TSH/Ua/CXR unremarkable. Plan? Atrial Fibrillation/Flutter Facts: irregularly irregular rhythm. Doubles mortality, Read more…
Dr. Freedman is back again with another Morning Report! To “P” or not to “P” Ddx for a regular, fast, narrow (or not) rhythm? ST AVNRT AVRT AVRT A Flutter A Tach +/- Abberancy What’s the atria doing and Where to look? Diagnostic tools at Read more…
Thanks to Dr. Freedman for today’s Morning Report! Fascicular Block (Hemiblock) Definition: Conduction delay in of the main divisions of the left bundle, either anterior or posterior LAFB Criteria: Dominant R waves in I, aVL Dominant S waves in II, III, aVF No evidence for any other Read more…
Today’s Morning Report is presented by Dr. Freedman! The Case: Left Ventricular Hypertrophy Definition: increased mass of the left ventricle How?: Things that cause increased afterload HTN Aortic Stenosis Coarctation Genetics HCOM Volume Overload? Mitral Regurg Aortic Regurg Why do we care? risk of development of CAD risk Read more…
Today’s Morning Report is presented by Dr. Freedman! Troponin-emia 101 Background Compromised of three subunits: T, I, and C Both T and I subunits are highly-specific for cardiac tissue Since 1995, has emerged as the cardiac biomarker of choice Cardiac Specificity Predictable time course Rises above 99th percentile Read more…