Author Archives: David Baumrind

59 Year Old Male–"Lifting Boxes": Part II, with a twist!

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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, […]

59 Year Old Male: "Lifting Boxes"

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This is part one of today's case study. As usual some information has been changed to protect patient confidentiality. EMS is called to the residence of a 59 year old male, who's chief complaint is chest discomfort.  As the crew enters the kitchen, they find the patient sitting in a chair surrounded by family members. […]

Snapshot Discussion: 64 Year Old Male–Chest Pain

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This is the discussion for "Snapshot: 64 Year Old Male–Chest Pain". First, let's talk about the patient presentation.What is concerning is the substernal chest pain, radiating to the shoulder and neck area. While this occurred about 30 minutes after exercise, it did not occur during exercise, so that is somewhat atypical. Still, enough red flags […]

Snapshot: 64 Year Old Male–Chest Pain

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Today we have a short "Snapshot" case…Just the down and dirty. You are called to an urgent care center for a 64 year old male, CC of substernal chest pain, which radiated to the right shoulder and neck area. He states the discomfort feels a little like "indigestion". This episode began just after finishing a […]

Discussion for "A Change of Pace: What Happened?"

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This is the discussion for "A change of Pace: What Happened?"  My apologies for the delay! Pacemakers are amazing pieces of technology. They have evolved continually, and have given patients an increasing quality of life where none existed before. However, with this amazing technology comes a level of complexity that also has not been seen […]

A Change of Pace: What Happened?

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Here is a challenging case this morning to stretch your mind… You are called to a 71 year old male feeling "sick". He has not felt well for the past 24 hours. He describes feelings of "general aches and pains". He has history of heart failure, for which he has an AICD. His vitals are […]

Discussion for 51 Year Old Male: Chest Pain

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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 […]

51 Year Old Male: Chest Pain

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Here is a great case submitted by faithful reader Niels, a Paramedic in Germany. As always, some minor information may have been changed to preserve patient confidentiality. Our case today takes us overseas, to the German countryside. It's a clear blue Monday morning, 11:40 am, when you and your partner are called to a 51 […]

"What Happened?"–Discussion

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This is the discussion to "What Happened?" You may wish to review the case here. Ok, let's review the initial 12 Lead: Just about everyone picked up on the infero-posterior STEMI. Where it got interesting for me, was determining what the rhythm was! At first glance, the rhythm was for the most part regular (note […]

What Happened?

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A 68 year old male, with no significant medical history, presents to the local ED (non-PCI) with chest pain. He had been doing some gardening, when he suddenly felt chest discomfort (8/10), non-radiating with diaphoresis. His wife drove him to the ED. Once there, he was given ASA and NTG, and the following ECG was […]

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