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CASE CONTINUED She was admitted to the ICU. Discontinue all negative chronotropic agents, since the risk of torsade is much higher with bradycardia or pauses. Smith has provided excellent overview of measuring and correcting QT interval in scenarios where QRS duration is prolonged (e.g., LBBB, ventricular pacing, etc.)." The plan: 1.
The patient was admitted to the ICU for close monitoring and electrolyte repletion and had an uneventful hospital course. Syncope and Bradycardia Syncope in a 20-something woman Long QT: Do not trust the computerized QT interval when the QT is long An Alcoholic Patient with Syncope Cardiac Arrest. Is it STEMI? What is going on here?
Because hyperkalemia kills by either VT or VF arrest, or by bradycardia with PEA arrest, this should be assumed to be VT until proven otherwise. He made it to the ICU, however the patient unfortunately expired approximately 24 hours after ICU admission. We set the machine to synchronized cardioversion.
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 mg/dL: The massive ST Elevation persists. What is going on here?
Upon arrival in the ICU, before getting Continuous Veno-Venous Hemodialysis (CVVHD), his potassium had risen again to 7.8 Hyperkalemia findings include the classic peaked T-waves, as well as the deadly B's of hyperkalemia: Broad (wide QRS), Brady (bradycardia), Blocks (AV blocks), and Bizarre. There is no ECG available from this time.
His temperature was brought back to normal over time in the ICU. Altered Mental Status, Bradycardia == MY Comment , by K EN G RAUER, MD ( 2/2 /2024 ): == Dr. Meyers began today’s case with the clinical challenge of asking you to identify the underlying cause of ECG #2. He was extubated and had normal neurologic function.
The patient stabilized and was transferred for ICU admission. Learning points: Your differential for wide QRS (by itself) and bradycardia (by itself) must include hyperkalemia. Labs resulted, showing a potassium of 8.0 mEq/L, glucose of greater than 900 mg/dL, and anion gap metabolic acidosis consistent with DKA.
He was admitted to the ICU and transferred emergently to a facility where he could undergo emergent dialysis as a part of further evaluation and management. ST elevation in aVL with reciprocal ST depression in the inferior leads Shock, bradycardia, ST Elevation in V1 and V2. The QRS is narrow and T waves are much less peaked.
She was resuscitated and admitted to ICU for presumed sepsis. Several days into hospitalization, she continued to have occasional episodes of sinus rhythm and sinus bradycardia with periods of Mobitz I AV block and 2:1 block. Meanwhile, the patient's native rhythm is sinus bradycardia with adequate perfusion.
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