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A 20-something presented after a huge verapamil overdose in cardiogenicshock. And she does not know that this is an overdose; she thinks it is a patient with chestpain!! Today's patient is a young male who presented in cardiogenicshock following a massive verapamil overdose. The initial K was 3.0
Written by Jesse McLaren Two patients in their 70s presented to the ED with chestpain and RBBB. Patient 1 : a 75 year old called paramedics with one day of left shoulder pain which migrated to the central chest, which was worse with deep breaths. Do either, both, or neither have occlusion MI? Vitals were normal.
ObjectiveAlthough the association between admission glucose (AG) and major adverse cardiac events (MACE) is well-documented, its relationship with 30-day MACE in patients presenting with cardiacchestpain remains unclarified.
He woke up alert and with chestpain which he also had experienced intermittently over the previous few days. The history in today's case with sudden loss of consciousness followed by chestpain is very suggestive of ACS and type I ischemia as the cause of the ECG changes. What do you think? This is an ominous sign.
Case submitted by Rachel Plate MD, written by Pendell Meyers A man in his 70s presented with chestpain which had started acutely at rest and has lasted for 2 hours. The pain was still ongoing at arrival. His initial troponin T was 15 ng/L (only two hours since pain onset). He underwent CPR and then was shocked out of VF.
Some patients have baseline RBBB with LAFB, but in patients with likely ACS, these are associated with severe infarction with cardiacarrest, cardiogenicshock or impending shock. Here are some cases of RBBB with LAFB: What is the Diagnosis in this 70-something with ChestPain?
A 56 yo f with h/o HTN and hypercholesterolemia called EMS from home after onset of L chestpain radiating to the left arm. She arrived comatose and in cardiogenicshock and the following ECG was recorded. Before EMS arrived, she had "seizure activity" and became unresponsive. She was intubated.
The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chestpain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. Written By Magnus Nossen — with edits by Ken Grauer and Smith. The below ECG was recorded.
Jesse McLaren (@ECGcases), of Emergency Medicine Cases Reviewed by Pendell Meyers and Steve Smith An 85yo with a history of hypertension developed chestpain and collapsed, and had bystander CPR. On arrival, GCS was 13 and the patient complained of ongoing chestpain. Vitals were HR 58 BP 167/70 R20 sat 96%.
All of the patients presented with chestpain , and they are all in triage. The patient died of cardiogenicshock within 24 hours despite mechanical circulatory support. Smith: This bizarre ECG looks like a post cardiacarrest ECG with probable acidosis or hyperkalemia in addition to OMI.
This pattern is essentially always accompanied by cardiogenicshock and high rates of VT/VF arrest, etc. The patient arrived to the ED in cardiogenicshock but awake. What is the Diagnosis in this 70-something with ChestPain? 68 minutes with chest compressions, full recovery.
The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chestpain to Dr. McLaren. An elderly man with sudden cardiogenicshock, diffuse ST depressions, and STE in aVR Literature 1.
But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chestpain was a little more intense, and the needed recovery period was longer in duration. Then, she attempted to reengage the activities at hand, and initially tolerated this well.
Written by Pendell Meyers An adult man presented with acute chestpain. See our other cases with similar patters, to burn this deep into your brain files: Smith : In my experience, these cases of LAD OMI with RBBB and LAFB are either about to arrest, post-arrest, and/or in cardiogenicshock.
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