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I also believe that we physicians and medics are eager to treat dysrhythmias, and we want to see them even when they are not there. We believe more research is needed in this area, as amphetamine derivatives are one of the most widely abused drugs worldwide, and we expect this problem to worsen in the future." Marcus, G. Hollander, J.
Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. She has done quite a bit of research on the topic. Given that chestpain is resolving at the time ECG #2 was recorded — this supports the concept of dynamic ST-T wave changes in this patient.
I remember Allie well from her days in the Research volunteer program at Hennepin. It was from a patient with chestpain: Note the obvious Brugada pattern. This was submitted by Alexandra Schick. Dr. Schick is a PGY3 at the Brown Emergency Medicine Residency in Rhode Island. The article is edited by Smith.
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). Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade.
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