EM Cases: ECGs

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Test your clinical skills and judgment from real live ED patients. Each case of the month includes a clinical scenario along with an image of a physical exam finding, an EKG, or a diagnostic test. No long cases or drawn out answers – just what is quick and essential.

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UNFINISHED CASE – Return Later

History:

A patient in their mid-60’s presents to the hospital with       denies syncope, palpitations, chest pain, SOB, leg swelling or pain, fever, cough or other complaints.

Exam:

Vital signs are normal.  The physical exam is also normal.

An ECG is done

COPY OF ECG HERE

Computer Read:

Other info:

What is the most likely cause of the ECG findings in this patient?

  • A) Anxiety/Panic 
  • B) Blood clot (PE)
  • C) Cardiac: ACS
  • D) Drug toxicity 
  • E) Electrolyte issue 

What is the most likely rhythm in this patient?

  • A) Sinus bradycardia with PAC’s
  • B) 1st degree AV block
  • C) 2nd degree AV block, type 1 
  • D) 2nd degree AV block, type 2
  • E) 3rd degree AV block 

 

SCROLL DOWN FOR THE EKG ANALYSIS & 1-MINUTE CONSULT

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ECG ANALYSIS, QUIZ ANSWER, CASE OUTCOME/PEARLS & 1-MINUTE CONSULT

My ECG interpretation (by Dr. D. Brady Pregerson of ERpocketbooks.com):

ANOTHER COPY OF ECG HERE

QUIZ ANSWER: What is the most likely cause of the ECG findings in this patient?

  • A) Anxiety/Panic – Should always be a diagnosis of exclusion and should not cause ECG changes beyond tachycardia.  If you chose this, slap yourself!
  • B) Blood clot (PE) – PE should always be on the radar
  • C) Cardiac: ACS – ACS should always be on the radar
  • D) Drug toxicity – not likely given other clinical information
  • E) Electrolyte issue – not likely given other clinical information

1-Minute Consult on this topic: Click HERE and scroll to proper page

Case Outcome:

Case Lessons:

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