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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.
The rhythm is atrialfibrillation. Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism. Now another, with ultrasound. Initial ROSC was obtained, during which this ECG was obtained: What do you think? The QRS complex is within normal limits. What is the Diagnosis?
Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. There is atrialfibrillation. Comments: STEMI with hypokalemia, especially with a long QT, puts the patient at very high risk of Torsades or Ventricular fibrillation (see many references, with abstracts, below).
A bedside POC cardiac ultrasound was done: Findings: Decreased left ventricular systolic function. Atrial Flutter is a type of atrial tachycardia which is "Macro-reentrant," meaning that the re-entry loop is quite large, encircling much of the atrium, and you can actually see that loop on the surface 12-lead as flutter waves.
Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. Good History and Physical exam, including a.
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