Tag Archives: Takotsubo Cardiomyopathy

58 year old female CC: Chest pain – Conclusion

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This is the conclusion to 58 year old female CC: Chest pain. Let's take another look at the 12-lead ECG. Remember, ST-elevation needs to be explained, and if the etiology involves myocardial infarction, urgent time-sensitive decisions need to be made. In this case, we have ST-elevation in leads V1-V5, which suggests the possibility of acute […]

76 year old female CC: Chest pain – Conclusion (Tako-Tsubo Cardiomyopathy)

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Here is the conclusion to the most recent case: 76 year old female CC: Chest pain. To see Part I click HERE. To see Part II click HERE. The patient was transported to the emergency department where she was treated for a possible acute coronary syndrome. Serial 12-lead ECGs and cardiac biomarkers were performed. This […]

76 year old female CC: Chest pain – The case for this being an acute anterior STEMI

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As many of you pointed out, the history and clinical presentation isn’t exactly screaming “Acute Coronary Syndrome!”

76 year old female CC: Chest pain

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EMS is called to the beach for a 76 year old female complaining of shortness of breath. Past medical history of emphysema. On arrival, the patient is found sitting in a beach chair alert and oriented to person, place, time, and event. She does not appear to be in any acute distress. The patient states […]

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Comments
Anthony Garlick
68 y.o. male with weakness: “Treat the monitor, not the patient?”
So my working clinical impression would be hypoglycaemia with possibly dehydration and an electrolyte imbalance. Reasoning for this is that the patient frusemide and metolazone are both diuretics are known to cause these problems. ECG does have a wide and bazar QRS complex with ? ? AV disassociation plus what looks to be peaked T…
2014-09-30 22:22:35
jason
68 y.o. male with weakness: “Treat the monitor, not the patient?”
I'm with Dave Eastman on this. I think it's hyper K+ and will treat as such. But I'll do that will I head to the PCI capable facility. Do I think there is an underlying STEMI? Nope, I sure don't. Do I know the computer has a hard time with false positives? yup. Am I…
2014-09-28 22:15:54
Rodrigo Furtado
68 y.o. male with weakness: “Treat the monitor, not the patient?”
I did forget, is it possible pacer is placed??? sorry that went right over my head.
2014-09-28 20:38:19
Rodrigo Furtado
68 y.o. male with weakness: “Treat the monitor, not the patient?”
1) Change to every lead? STEMI is questionable on my Dx # 6 on a list of 5. IF my recall on this, IF a Global presentation of ST change with QRS Change: a) STEMI is extremely unlikely or NOT STEMI b) start looking for mechanical problems ( tamponade) or chemical/ electrical (electrolyte imbalance or…
2014-09-28 20:34:36
Dave Eastman
68 y.o. male with weakness: “Treat the monitor, not the patient?”
My first thought was hyperkalemia. If the pt is stable, begin with Ca++ & bicarb. Consider albuterol. Serial 12-leads. Start toward PCI capable facility. If it is hyperkalemia, initial treatment should begin to improve pt's condition and there is no harm caused from the increased transport time. If there is an underlying MI as well,…
2014-09-28 18:05:12

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