Archive for October2014

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 […]

Understanding Amiodarone

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Recently, I was part of a short discussion between fellow healthcare providers of different levels of care, about Amiodarone and its expected effects on the heart during Ventricular Tachycardia (VT). I figured, I could break it down and write a short summary of how it works.   Most healthcare providers are familiar, or at least have […]

Calcium and Hyperkalemia

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Calcium Chloride/Gluconate are used during Hyperkalemia induced ECG changes to reduce Serum Potassium. The answer is: False! The majority of Potassium in our body is found intracellular. Only a very small percentage (about 2%) is found extracellular, ranging between 3.5- 5.5 mEq/L. As extracellular Potassium levels increase, the action potential threshold decreases, for example, instead of […]

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 […]

68 y.o. male w/ weakness: conclusion – “Treat the monitor.”

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But perhaps not the computer… Recap of the case: A patient with CHF, COPD, and diabetes called after falling, apparently due to weakness. Their ECG was recorded by the paramedic: Interpretation: The underlying rhythm is unclear, due to artifact, but there are very wide QRS complexes. The computer measures the QRS as 158 ms, which […]