The 12 Rhythms of Christmas: Atrial Flutter

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This article is the third in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. This is a new edit of the first article I ever published on my personal blog, so it may […]

The 12 Rhythms of Christmas: Sinus Bradycardia

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This article is the second in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. We were almost day behind kicking off the series (a peril of posting around the holidays), so I’m going […]

The 12 Rhythms of Christmas: Sinus Tachycardia

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This article is the first in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. Sinus Tachycardia It’s one of the first arrhythmias we all learn and it seems so simple. Sinus tachycardia is […]

AMS, hypotensive with HR > 150: Cardiovert?

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  EMS was called for middle-aged man, found slumped over a table at restaurant. He had quite a poor mental status and could not offer any medical history. Per the staff he had just arrived, and not eaten or drank anything. Although he is carrying a home glucometer, his blood sugar is 160. He has […]

Transcutaneous pacing: “Put it up to eleven!”

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Dramatic ECG! But there is a short answer, actually just a number. And as the title suggests, the answers to this case are (both literally and figuratively) 11. But what are the questions? The Case EMS brought in a middle-aged male with altered mental status and an ill appearance.Over the past 3-4 days he had […]

ST-segment elevation in lead aVR. Is this a STEMI equivalent?

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EMS was called for a young adult male who had collapsed at home. He had been walking through the kitchen when he complained of some chest discomfort, appeared to perhaps have trouble breathing, and then had a syncopal episode. He had a PMHx history of trisomy 21, sleep apnea, DM type 2, and right-sided CHF […]

Heroin Withdrawal: QT Prolongation & Torsade de Pointes

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This is the case of a 61 year old male who presented to the emergency department with a chief complaint of nausea and vomiting. The patient was alert and oriented, reporting intermittent chest pressure for the last 12 hours that he rated as a 9/10 pain level. He also reported multiple syncopal episodes within the […]

Spot the STEMI #1

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You have a 50/50 shot at getting this one right. Are you feeling smart… or lucky? Two 50-year-old men present complaining of chest pain x 1 hour. One patient is suffering from a very subtle acute STEMI while the other has a non-cardiac cause for his chest pain. Which patient is experiencing the subtle STEMI? […]

Conclusion to 43 Year Old Female – Chest Discomfort After Eating

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This is the conclusion to our case from last Saturday. I suggest reviewing the original case presentation before diving into the discussion here. A 43-year-old female presents feeling like there’s a knot behind her sternum. It began suddenly just after eating lunch. This is her initial ECG: There is apparent ST-elevation in leads V1–V3. The […]

“You Make the Call” — 86 Year old Female: Dizzy

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  It is a beautiful September morning when the tones go off for a 86 year old female, “altered mental status”. “Guess breakfast will have to wait”, as you and your partner head towards the residence. As you enter the one level home, you are directed to a back bedroom where you find your patient […]

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