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A young man presented with a gunshot wound to the right chest, with hemo-pneumothorax and hemorrhagic shock. He got a chest tube and intubation and massive transfusion and stabilized. CT of chest showed the bullet path through his right lung but nowhere near his heart. But he did get an EKG: What is this?
This 54 year old patient with a history of kidney transplant with poor transplant function had been vomiting all day when at 10 PM he developed severe substernal crushing chestpain. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. He had this ECG recorded. Are the lungs clear?
A man in his 40's with a h/o coronary disease complained of sudden dizziness and chestpain. Alternatively, it could be posterior fascicular ventricular tachycardia. Either the PSVT was broken and restarted, or there is sinus tachycardia. Maybe the patient has dehydration, sepsis, hemorrhage, or PE.
Chest trauma was suspected on initial exam. The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated. RBBB in blunt chest trauma seems to be indicative of several RV injury. ST depression.
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. A slightly prolonged QTc ( although this is difficult to assess given the tachycardia ).
Given her reported chestpain, shortness of breath, and syncope, an ECG was quickly obtained: What do you think? It is difficult to tell if there is collapse during diastole due to the patient’s tachycardia. MY Thoughts on the ECG in Figure-1: The rhythm in ECG #1 — is sinus tachycardia at ~125/minute.
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. The patient continued having chestpain. These diagnoses were not found in his medical records nor even a baseline ECG.
A man in his 40s with multitrauma from motor vehicle collision Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated. Sinus Tachycardia ( common in any trauma patient. ). ST depression. Myocardial Contusion?
His comments/questions are inserted below the ECG: A 50-something woman presented with 3 days of intermittent chestpain that became worse on the day of presentation, with diaphoresis and radiation to the left arm, as well as abdominal pain. This is her ECG: An obvious STEMI, but which artery? Knotts et al.
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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