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…
Beware Automated Synchronization for Cardioversion!
This was provided by our electrophysiologist at the Hennepin Heart Center. The patient was having symptomatic atrial fibrillation and was to…
DIffuse ST Elevation with Apical Ballooning: is it Takotsubo Stress Cardiomyopathy?
A 33 year old male had 2 days of chest pain, intermittently relieved with acetaminophen (paracetamol) and diclofenac. He came to the ED…
Ultrasound Before ECG for Chest pain? Whoever gets there first. Use of Speckle Tracking.
A male in his mid 30s with no cardiac history but some cardiac risk factors had onset of chest pain and arrived in the ED within 30 minutes of…
Anatomy of a Missed LAD Occlusion (classified as a NonSTEMI)
A male in his 50’s called 911 for constant 8/10 midsternal chest pressure. Here was his prehospital ECG: Computerized QTc is 423…
Subtle Anterior STEMI Superimposed on Anterior LV Aneurysm Morphology
A male in his early 30s was playing soccer when the ball hit him in the chest. At some point after this, he began having chest pain.…
Dyspnea on Exertion in a Middle Aged Woman.
A middle-aged woman presented to the ED with increasing dyspnea on exertion. She had a normal physical exam except for a heart rate…
Massive Osborn Waves of Severe Hypothermia (23.6 C), with Cardiac Echo
This patient was found down in the Minnesota Winter. He felt cold and was unresponsive. He had palpable pulses at a rate of 30,…