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…
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…
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…
67 yo F with permanent atrial fibrillation. Why is her rhythm regular? Best answer by May 18th at noon is our winner!
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!
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…
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…