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Pacemaker Malfunction

8/24/2015

0 Comments

 
HPI:
90 y/o woman h/o sick sinus syndrome, AF, and a pacemaker presents with atypical CP.  Troponins are negative, CTPA is negative for PE.  She denies palpitations, shock-like sensations, or chest wall contractions. Palpated HR corresponds with QRS complexes on the monitor.

EKG:
Picture
Question:
What's going on with this pacemaker? Is the malfunction the cause of her symptoms?
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Is This Sinus?

8/17/2015

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HPI: 50 y/o male with hx of COPD, heroin use, and recently diagnosed cor pulmonale presents with 3 weeks of lower extremity edema. No chest pain, shortness of breath, or palpitations. An EKG is obtained in the emergency department.
Picture
Question: 
  • What does this EKG tell you about the etiology of this patient’s lower extremity edema?
  • Is this EKG in sinus rhythm?


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STEMI Without The "STE"

8/10/2015

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HPI: 57 y/o woman with remote hx of CABG/PCI presents with 2 hrs of 6-10/10 substernal chest tightness and SOB. No recent cardiac events/complaints. Initial troponin is 1.48.
Picture
Question:  Is this patient experiencing a STEMI despite the lack of ST elevations ≥1mm?  How would you diagnose this and explain to your cardiology consultants?
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    Picture
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  • RESIDENCY
    • About CMC
    • Curriculum
    • Benefits
    • Explore Charlotte
    • Official Site
  • FELLOWSHIP
    • EMS
    • Global EM
    • Pediatric EM
    • Toxicology >
      • Tox Faculty
      • Tox Application
    • (All Others)
  • PEOPLE
    • Program Leadership
    • PGY-3
    • PGY-2
    • PGY-1
    • Alumni
  • STUDENTS/APPLICANTS
    • Prospective Visiting Students
    • UNC/Wake Forest Students
    • Healthcare Disparities Externship
    • Resident Mentorship
  • #FOAMed
    • EM GuideWire
    • CMC Imaging Mastery
    • Pediatric EM Morsels
    • Blogs, etc. >
      • CMC ECG Masters
      • Core Concepts
      • Cardiology Blog
      • Dr. Patel's Coding Blog
      • Global Health Blog
      • Ortho Blog
      • Pediatric Emergency Medicine
      • Tox Blog
  • Chiefs Corner
    • Top 20
    • Current Chiefs
    • Schedules >
      • Conference/Flashpoint
      • Block Schedule
      • ED Shift Schedule
      • AEC Moonlighting
      • Journal Club/OBP/Audits Schedule
      • Simulation
    • Resources >
      • Fox Reference Library
      • FlashPoint
      • Airway Lecture
      • Student Resources
      • PGY - 1
      • PGY - 2
      • PGY - 3
      • Simulation Reading
      • Resident Wellness
      • Resident Research
      • Resume Builder
    • Individualized Interactive Instruction