Altered Mental Status, possible ingestion. What does the ECG show?
A middle aged man was heard to be falling in his apartment. He was found very agitated, intermittently screaming (and on presentation…
Atrial Fibrillation with RVR and Inferoposterior ST elevation (Injury Pattern)
This is an old post from June 2009 that has not received much attention, but should. Take a look! This 80 yo woman had been increasingly…
Young man with syncope while riding a bike [Arrhythmogenic Right Ventricular Dysplasia (ARVD)]
This 31 yo who is otherwise healthy had sudden syncope while riding a bike. He remembers looking down, then becoming dizzy,…
A Southeast Asian with Tachycardia and Hypotension after taking a dangerous herbal medication (Bidirectional Ventricular Tachycardia from Aconite Poisoning)
I published this case in Annals of EM 6 years ago. I figure it’s ok to put it here now after all these years, especially since one…
Left Bundle Branch Block and Left Anterior Descending Artery occlusion: Serial ECGs then T-wave inversion after reperfusion
A 50 yo male presented with chest pain. This ECG was recorded at 0415. There is sinus tachycardia. There is left bundle branch…
Should we activate the cath lab if the STEMI is spontaneously reperfused?
Will be on vacation until August. Last post until then! I received a question yesterday: “If spontaneous reperfusion (or…
Wait until after the ECG to give Nitroglycerine
Here is the ED ECG of a 58 yo male whose chest pain is resolved: There is sinus rhythm with a PAC (which has aberrant conduction…
Missed STEMI, spontaneously reperfused
Click here for other very instructive cases of missed STEMI. This is a 48 yo female with no risk factors for CAD had sudden onset of arm…
Would you activate the cath lab prehospital?
A 54 yo with history of hypertension awoke in the AM with substernal chest pain. It did not abate, so at 0930, he called 911.…
Chest pain, SOB, and tachycardia. What is the rhythm? Is it MI?
This was sent to me by a reader from India (Thank you, Rama Krishna). The patient presented recently (age unknown). He had a…