Remove AFIB Remove Chest Pain Remove ICU
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20-something with huge verapamil overdose and cardiogenic shock

Dr. Smith's ECG Blog

And she does not know that this is an overdose; she thinks it is a patient with chest pain!! He was admitted to the ICU and was unstable, in shock, overnight. Case Continued: He was stabilized on more calcium, pressors, and high dose insulin. 3 hours later, this was recorded at a K of 2.8 mEq/L and total calcium of 14.7

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A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

The pacing rate was increased without clinical improvement and the patient was transferred to the ICU for closer monitoring/treatment. The patient also has a history of AFib and HFmrEF ( = H eart F ailure with M inimally- R educed E jection F raction ). This patient presented to the ED “after a couple of days of chest discomfort”.