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Written by Pendell Meyers A man in his 40s called EMS for acute chestpain that awoke him from sleep, along with nausea and shortness of breath. His history included known heart failure with prior EF 18%, insulin dependent diabetes, and polysubstance abuse. Vitals were within normal limits except for tachypnea.
Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chestpain and nausea. He reported a history of “Wolf-Parkinson-White” and “heart attack” but said neither had been treated. Am Heart J 1999;137:799–805.
There was apparently no syncope and he had no bony injuries, but he did complain of left sided chestpain. His chest was tender. Accelerated ventricular rhythm in children: a review and report of a case with congenital heartdisease 3. A bedside cardiac ultrasound was normal. He wrote: "ECG 1 - shows wide ???IVCD
However, heartdisease is the leading cause of death for women in the United States, making early detection and proactive management essential. Heartdisease affects millions of women globally. In the United States alone, nearly one in five women die from heartdisease each year.
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chestpain similar to his prior MI, but worse. The pain initially started the day prior to presentation. The ST elevation from today is ~0.2
He had concurrent sharp substernal chestpain that resolved, but palpitations continued. Over past 3 months, he has had similar intermittent episodes of sharp chestpain while running, but none at rest. A 50-something presented with s udden onset palpitations 8 hrs prior while sitting at desk at work.
Share ChestPain Symptoms There is no role for CT Calcium Scoring in the setting of someone with chestpain symptoms suspected to be from a narrowed coronary artery. This approach also reduces death from heartdisease and heart attacks by 41% compared to conventional approaches such as exercise stress testing 2.
The patient's chestpain had resolved by the time of the ECG 2. But it does prove that the patient has coronary disease and makes the probability that his chestpain is due to ACS very very high. He presents with an episode of brief, new-onset chestpain that had resolved by the time E CG # 1 was obtained.
Written by Pendell Meyers, few edits by Smith A man in his 60s with history of stroke and hypertension but no known heartdisease presented with chestpain that started on the morning of presentation at around 8am. Here is his triage ECG when he presented at 1657: What do you think?
While fully acknowledging that "Sometimes ya gotta be there!" — in order to optimally assess the patient — the clinical definition of hemodynamic stability is for the patient to be without significant symptoms such as chestpain, shortness of breath, hypotension and/or mental status changes — as a direct result of the fast heart rate.
As always — it’s nice when we have “the Answer” , here in the form of an EP study documenting the absence of any SVT — with confirmation that the rhythm is VT. Even before you look at the ECG — this statistic increases to over 90% if the patient in question is older and has underlying heartdisease.
This can be a critical piece of information — since our assessment might be quite different if this “baseline” tracing was obtained in the ED at the time of a previous visit for chestpain ( in which case — this previous ECG might not be a “baseline” tracing after all. ).
She was noted to be tachycardic and her heart sounds were distant on physical exam. Given her reported chestpain, shortness of breath, and syncope, an ECG was quickly obtained: What do you think? This patient was reported to have distant heart sounds but was not hypotensive and did not have JVD according to documentation.
Her group also provided education to obstetrics/gynecology clinicians about the numerous conditions that occur during pregnancy that can increase a woman's risk of future heartdisease. For instance, Volgman co-authored a paper highlighting how the Rush Heart Center for Women treats patients with ischemic heartdisease (IHD).
Check : [vitals, SOB, ChestPain, Ultrasound] If the patient has Abdominal Pain, ChestPain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Vasovagal predisposition (warm crowded place, prolonged standing, fear, emotion, pain: (-1) 2.
Erectile dysfunction (ED) is a common concern among men, especially those dealing with cardiovascular disease. The connection between heart health, vascular risk factors, and sexual function is well-documented, with poor cardiovascular health often leading to or exacerbating erectile issues.
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