EKG

ECG PEARLS: Beware the Slow Mimics of Ventricular Tachycardia

by Amal Mattu, MD on August 24, 2010

A 37-year-old man presented to the emergency department with severe respiratory distress. He reported a history of hypertension, diabetes and end-stage renal failure for which he received hemodialysis three times per week. However, he admitted to missing his last two dialysis sessions.

Don't Forget Lead aVR...

by Patrick Shannon, DO & Zach Patrick, DO on July 15, 2010

title A 39-year old female presents to our emergency department with complaints of “worsening of heartburn”. The patient states that for several months she has had episodic indigestion and chest discomfort. She has been taking antacids for several weeks as prescribed by her family doctor without improvement.

Confirming G-Tube Placement

by Teresa Wu, MD & Brady Pregerson, MD on June 28, 2009

"I think my child has swan flu!” You pause and try your hardest to maintain that poker face you’ve perfected. “I saw it on the news,” she continues, “and then my daughter was at Disney World running around with all these swans yesterday. I think they were contagious!”

ECG + Ultrasound = ?

by Teresa Wu, MD & Brady Pregerson, MD on June 18, 2009

What does the EKG show? What should you do next?

The Chest Pain Evaluation: Testing the Tests

by Kevin Klauer, DO on October 31, 2008

Although these CDRs summarize what you should be looking for, regarding history, physical examination and diagnostic criteria that put your patients at risk for ACS, they come up short on real-world application. The value, in my opinion, is knowing what those risky elements are, as opposed to actually calculating a TIMI score.

Clinical Decision Rules: Are They Valid?

by Erik Hess, MD on October 30, 2008

Chest pain is a diagnostic dilemma for the emergency physician. Data from the United States suggest that 2.1% of patients with acute myocardial infarction and 2.3% of patients with unstable angina are misdiagnosed. Information obtained from the history, the initial 12-lead ECG, and a single set of cardiac markers does not have sufficient sensitivity to identify those patients who are safe for early discharge.

Troponins in Acute Pulmonary Embolism

by Christopher Carpenter, MD, MSc on November 1, 2007

A hemodynamically stable middle-aged male presents to your ED with non-pleuritic chest pain and multiple cardiac risk factors. Your diagnostic evaluation includes includes a Troponin-I which unfortunately returns at 0.5 ng/mL, although no ECG changes are noted.

Tracings: Weak and dizzy

by Vernon Stanley, MD, PhD on August 31, 2007

A 40-year-old male presents to the ED after a syncopal episode. In his past medical history he relates a history of frequent debilitating “dizzy spells”. After reviewing his ECG your interpretation/advice is...