Remove Echocardiogram Remove Embolism Remove ICU
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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

He was started on a heparin drip and CTA of the chest was ordered to rule out pulmonary embolism. Echocardiogram showed severe RV dilation with McConnell’s sign and an elevated RVSP. The patient was upgraded to the ICU for closer monitoring. In fact, Kosuge et al. In fact, Kosuge et al. Now another, with ultrasound.

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Abstract 4140751: “A silent death: Right heart clot in transit” Acute sub-massive pulmonary embolism

Circulation

He was administered a therapeutic dose of low-molecular weight heparin and transferred to the ICU. Despite his large clot burden, there was absence of obstructive shock.Transthoracic Echocardiogram and bilateral duplex venous ultrasound were obtained to evaluate for right heart strain and clot burden.

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"Pericarditis" strikes again

Dr. Smith's ECG Blog

The next morning the patient went for his routine echocardiogram, where the operator noticed a dilated aortic root at 5.47 in the ICU but survived with excellent function. Here is a quote from his initial cardiology admission note (after cath was done showing no acute culprit): ".chest Troponins gradually trended down from 0.19