Thanks for all the responses and sorry for the delay in posting this answer. Ritchie hit it right on the head. The patient was diagnosed with West Nile Encephalitis. The WNV PCR eventually came back positive. While the diagnosis was not made in the emergency department, the treating physician had Read more…
This 18yo F presented with one episode of chest pain which lasted a 2-3 minutes, was left sided, sharp and 8/10. Vitals in the ED were BP 112/71 HR 106, RR 18, T98.9. The above EKG was obtained as part of the workup for ACS. Post your questions/comments Read more…
This case starts with a pretty common presentation to the emergency department: AMS. As with most cases of AMS in the ED, the patient had a CT head done during his ED course. However, our patient also had an MRI done before he left the ED. While MRI’s are typically Read more…
First of all thanks to those of you who interpreted this EKG. It’s a difficult one to begin with and to do it without a history is even harder. So lets fill in some of the blanks about this patient’s history. This was a 69 y/o woman w/ PMH of Read more…
Here’s this months EKG! As usual… post your comments and questions below… I will post the answer on Friday!
So to recap… our case was that of a 44yo F presenting from St. Vincents with fever, AMS and abdominal pain. Further pertinent negatives ans positives that were obtained through your questions were the following: No hx of DVT, abnormal rhythm, IVDU, valvular HD, HIV, hemoglobinopathy. No known medical problems. No FH Read more…
This month’s image is actually a CT scan. Take a look at the video below. 44yo woman presented to the ED. She just got off a plane from St. Vincents. Her chief complaint was fever, altered mental status and abdominal pain. During the course of her ED visit she had Read more…
You’re working one night in UHB and you see this patient roll into the resus bay. Its a woman in her 60s with a history of scleroderma who’s chief complaint is shortness of breath. The tech hands you the following EKG: Please reply in the comments with your Read more…
Here’s the answer to our last EKG! The major finding in this EKG is the abnormal rhythm. Looking at the rhythm strip (II) the patient starts out in sinus rhythm. Then after the 4th QRS we start to see additional p-waves. The rest of the rhythm strip shows an ectopic Read more…
Here is this weeks EKG! Post your reading and your plan in the comments. I’ll post the answer next week!