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A bedside POC cardiac ultrasound was done: Findings: Decreased left ventricular systolic function. Later, he underwent a formal echocardiogram: Very severe left ventricular enlargement (LVED diameter 7.4 There is atrial activity before every QRS, but that activity has negative polarity, so it is not sinus rhythm.
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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