Archive for May2011

58 year old female CC: Chest pain

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EMS is called to the residence of a 58 year old female complaining of chest pain. On arrival the patient is found walking around the kitchen. She is anxious and hyperventilating. Past medical history: Hypertension (controlled with diet and exercise) HTN Medications: Xanax The patient is asked to sit down in a kitchen chair and […]

Found on the LIFENET 05/2011

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Found on the LIFENET. What is your impression of this ECG?   *** UPDATE *** Consider this recent case from Dr. Smith's ECG Blog. ST-elevation in aVR, with widespread ST-depression "ST elevation in aVR is often thought to represent left main occlusion. However, it really just signifies widespread and diffuse subendocardial ischemia which could be […]

82 year old male CC: Shortness of breath – Conclusion

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This is the conclusion to 82 year old male CC: Shortness of breath. Let's take another look at the 12-lead ECG. This ECG shows a severe bradycardia. We need to ask a couple of very important questions. Is the patient stable or unstable? The patient is unstable. In fact, the patient is periarrest. We cannot […]

82 year old male CC: Shortness of breath

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Here's an interesting and somewhat unusual case submitted by a faithful reader who wishes to remain anonymous. EMS is called to the residence of a 82 year old male complaining of shortness of breath and weakness. On arrival the patient is found slumped sideways in a chair. He is weak and in significant distress, repeating, […]

88 year old female CC: Chest pain – Conclusion

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This is the conclusion to 88 year old male CC: Chest pain. Let's take another look at the 12-lead ECG. This ECG shows acute STEMI in the presence of left bundle branch block. It's also an excellent example of the value of using "excessive discordance" to identify acute STEMI in the presence of left bundle […]

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