Remove Dysrhythmia Remove Hospital Remove Ultrasound
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An adolescent with trauma, chest pain, and a wide complex rhythm

Dr. Smith's ECG Blog

This case was sent by Dr Avinash Krishnamurthy, a fine emergency medicine resident from Australia Cairns base hospital Case : An adolescent male had a mechanical fall and injured his left shoulder and arm. A bedside cardiac ultrasound was normal. His chest was tender. Most physicians, at first glance, get this wrong. What is it?

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Severe shock, obtunded, and a diagnostic prehospital ECG. Also: How did this happen?

Dr. Smith's ECG Blog

On arrival, the patient was in shock, was intubated, and had an immediate cardiac ultrasound. What does a heart look like on ultrasound when the EKG looks like that? Here you go: It's not the world's greatest cardiac ultrasound video, but it does appear to show poor function and low volume. They transported to the ED.

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

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STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. Could the dysrhythmias have been prevented? Severe hypokalemia in the setting of STEMI or dysrhythmias is life-threatening and needs very rapid treatment. He was managed medically with Clopidogrel. Learning Points: 1.

STEMI 52
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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

He spent almost 2 months in the hospital, and reportedly made a full neurologic recovery. Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism. Now another, with ultrasound. This patient arrested shortly after hospital arrival. He was prescribed apixaban. This is a quiz.

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The three things that can go wrong with the heart

Dr. Sanjay Gupta

Echocardiography – We can use ultrasound to visualize the heart and look at how well it pumps. The heart is an electrical organ and occasionally the electrics can choose to malfunction and the patient may develop a heart rhythm disturbance or a dysrhythmia such as AF or SVT or VT. This is termed as diastolic dysfunction.

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New Onset Heart Failure and Frequent Prolonged SVT. What is it? Management?

Dr. Smith's ECG Blog

A bedside POC cardiac ultrasound was done: Findings: Decreased left ventricular systolic function. The patient was given furosemide and admitted to the hospital. A diagnostic NT-proBNP cutoff of 900 pg/mL has been suggested in adults 50-75 years of age in absence of renal failure."