Author Archives: Vince DiGiulio

The 12 Leads of Christmas: Lead I

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This article is the first in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. The Lead I Sign This patient has COPD.   So does this patient.   Also, this patient.   How do I know that? Well, I met the patients […]

Conclusion to Snapshot Case: 85 Year Old Male With Chest Pain

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This is the conclusion to the Snapshot Case from a couple of days ago. If you haven’t already done so, I suggest reviewing the very brief initial case description. Here again is the EKG from Tuesday’s case. This tracing is nearly pathognomonic for true occlusion of the left main coronary artery (LMCA), resulting in a […]

Snapshot Case: 85 Year Old Male With Chest Pain

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Snapshot cases are EKG’s where we do not have good patient follow-up or sometimes even clinical information but still feel there are worthwhile learning points to convey. This is an old case we’ve actually featured on the blog before, but today we’re going to do so with a different focus. This ECG is from an […]

What it Looks Like: Cardiac Arrest

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This article is a quasi-cross-post from the website of our good friend Brandon Oto at EMS Basics. He’s been gracious enough to allow us to adapt the original post from his What it Looks Like series over here. We suggest that you go check out the work he does on his site; it’s the epitome of […]

Conclusion to 83 Year Old Male: Shortness of Breath

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Last week we presented the ECG of a patient experiencing progressively worsening shortness-of-breath over the course of a day and some marked ECG abnormalities. If you haven’t done so already, it would probably be a good idea to check out the original post first. Strap in, this is going to be a thorough discussion. Here […]

83 Year Old Male: Shortness of Breath

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You are called to the residence of an 83 year old male with a chief complaint of shortness of breath. On arrival you find a sick-appearing gentleman working hard to breath. He states that he woke up feeling a bit weak this morning with dyspnea-on-exertion that it has gotten progressively worse over past 12 hours—to […]

The 360 Degree Heart – Part II

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The first post in our “360 Degree Heart” series attempted to visualize how the different frontal plane (limb) leads relate to one another. We also introduced the concept of “negative leads,” which are just the standard leads flipped upside down. If you didn’t read that post it would probably be helpful to start there. This […]

The 360 Degree Heart – Part I

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The hexaxial reference system. If I asked you to imagine how the limb leads “look” at the heart you would probably picture something like the image below: Notice those gaps in the limb leads? They don’t really exist; they’re an illusion. This isn’t something that is commonly emphasized when the cardiac axis is being taught […]

Conclusion to 80 Year Old Male: Fall

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This is the conclusion to 80 Year Old Male: Fall. If you do not remember the particulars, check out the original post and then come back here to find the “answer” and summary. Case Review You arrived on scene to meet an 80 year old patient who was found on the floor after suffering what […]

80 Year Old Male: Fall

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A previously well 80-year-old experienced a fall at his home where he lives alone. He was walking from the living room to the kitchen when suddenly he found himself on the ground, which he attributes to tripping on the runner rug in the hallway. “My son has been telling me to get rid of that […]

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