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Taking a step back , remember that sinus tachycardia is less commonly seen in OMI (except in cases of impending cardiogenicshock). Answer : Bedside ultrasound! Smith : RV infarct may also have this appearance on ultrasound. So hypoxia without B lines on lung ultrasound strongly weights toward PE. Both were wrong.
Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.
I would do bedside ultrasound to look at the RV, look for B lines as a cause of hypoxia (which would support OMI, and argue against PE), and if any doubt persists, a rapid CT pulmonary angiogram. Figure-2: From Grauer K: ECG Pocket Brain-2014 ePub — regarding "My Take" on defining the ST segment baseline.
An elderly man with sudden cardiogenicshock, diffuse ST depressions, and STE in aVR Literature 1. Methods STEMI activations between January 2014 and April 2018 at the University of Arizona Medical Center were identified. A emergent cardiology consult can be helpful for equivocal cases. Left main? 3-vessel disease? Knotts et al.
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