Delirium and Physostigmine: ECG helps in Management
This patient took an unknown overdose and was delirious. The axillae were dry. Due to delirium and dry skin, there was suspicion…
Weakness and Dyspnea with a Sine Wave. It’s not what you think!
I don’t have all the clinical data on this patient, and unfortunately the ECGs are of low resolution, but they are good enough. Case A…
A 50-something male with Dyspnea
A middle-aged male presented with dyspnea. An ECG was recorded. What is going on? See below. There is sinus rhythm. There is…
Hypothermia and Right Bundle Branch Block, with ST Elevation?
This patient was found outside in the cold, unresponsive, hypotensive, and underwent brief chest compressions by EMS. Here is his ED 12-lead…
Interesting Left Main Occlusion….
Many believe that left main occlusion results in diffuse ST depression with ST elevation in aVR. This is not true, as I write about in…
How are these cases related?
I saw these two cases on the same day. This patient had a GI bleed and a massive transfusion: What is it? This patient had a history of…
Wide Complex Tachycardia in a 20 something.
This was sent by a former resident. He will remain anonymous because his identity could compromise patient confidentiality. Case A…
New Left Bundle Branch Block (LBBB) and Dyspnea
It is important to remember that the latest (2013) ACC/AHA STEMI guidelines removed New Left Bundle Branch Block (LBBB) as an indication for…
A Relatively Narrow Complex Tachycardia at a Rate of 180.
I received a text message with this image: “Cardioversion didn’t work. Any thoughts?” What do you think? The…
ED Case of Catecholaminergic Polymorphic Ventricular Tachycardia
This case was provided by a reader; there are missing details, but I believe it is still instructive. Case Presentation First ED presentation…