This is the discussion for “70 Year Old Male: Short of Breath“. Tough case. Lots of excellent comments and observations from our readers. Right off the bat, the patient’s presentation offered a major distraction: the recent eye surgery resulting in the old “eye patch presentation”. Confounding the situation further was the lack of any cardiac […]

  It’s a sunny morning, and your EMS unit is dispatched to a residence for an 87 year old male with difficulty breathing.   You arrive on scene before the fire engine and enter the residence. Upon entering the bedroom, you find an elderly male, sitting on the edge of the bed, vomiting. He is alert and oriented x 4 (person, […]

Here’s my presentation from the VA EMS Symposium on 11/08/2013. (This content is no longer available.) See our comprehensive video-based 12-lead ECG course at ECG Medical Training.

The original presentation of this case appeared as  "What's Wrong with Mr. Wilson?"… You can read the original post here. Much has been written lately about RBBB abnormalities that were missed.  Dr. Smith has recently posted two cases here, and here discussing this. First, let's review the 12 lead of a typical RBBB. When learning […]

On Monday, the American College of Cardiology Foundation and the American Heart Association released the 2013 Guidelines for the Management of ST-Elevation Myocardial Infarction. Their last updates to these guidelines were in 2004 and 2006, so this is an important milestone. If you have been following our blog and podcast, most of the changes will […]

This is the conclusion to 53 year old male: Severe leg pain. You may wish to review the case. Before we begin, my apologies for the delay in posting this conclusion. I live in coastal NY, and we got hammered by Hurricane Sandy. It has taken me a little time to get all caught up. […]

This is the conclusion to a 51 year old female CC: Near Syncopal Episode. If you haven't read the first part we highly recommend it! When we left off, our crew was attending to a 51 year old female who had almost passed out in a stadium tunnel during a college football game. We received […]

This is the discussion for 63 year old male CC: Substernal Chest Pain, brought to you by Dr. Brooks Walsh of Mill Hill Avenue Command and Doc Cottle's Desk. Be sure to review the first part! When we last left off, our patient was a 63 year old male complaining of substernal chest pain which awoke […]

This is part II to 59 year old male–"Lifting Boxes". You may wish to review the case. Let's review the ECG: There is sinus rhythm at about 90 bpm. Some of you saw a slight bit of ST elevation in the inferior leads, and maybe an abnormal aVL. Perhaps? Perhaps not? V1-V4 look possibly abnormal, […]

Here is the conclusion to 51 year old male: Chest Pain. You may wish to review the case. Here is the ECG again:   There is a regular sinus rhythm at a rate of about 70. The QRS is narrow. The axis is normal, at about 15 degrees. Let's take a look at the constellation […]