Triage: Decreased PO intake since Tuesday with associated vomiting, feeling weak, states hes lost 19lbs in 2 months
History of Present Illness: A man in his mid 50’s presents with 2 months of weight loss of 20 pounds due to anorexia and 2 days of generalized weakness and vomiting. He denies abdominal pain or diarrhea. He does have a history of HTN, alcohol use disorder and an episode of infectious colitis about 5 months ago. He says he has been sober for 3 weeks
Vital Signs: 36.7, pulse of 122, RR of 16 and BP of 139/66. He is hard of hearing and a bit stinky
Physical Exam: Very thin but no cachectic. Mild epigastric tenderness
An ECG is done
Computer Read: Sinus tach at 116, ST deviation and moderate T wave abnormality consider inferior ischemia
What is the most likely cause of ECG findings in this patient?
- A) None of the below
- B) Blood clot (PE)
- C) ACS
- D) Drug toxicity
- E) Electrolyte issue
NSWERS & 1-MINUTE CONSULT
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THE EMERGENCY MEDICINE POCKETBOOK TRIFECTA
- Emergency Medicine 1-Minute Consult, 5th edition
- A-to-Z EM Pharmacopoeia & Antibiotic Guide, 4th edition
- 8-in-1 Emergency Department Quick Reference, 5th edition
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My ECG interpretation:
ANSWER:
- A) None of the below
- B) Blood clot (PE)
- C) ACS
- D) Drug toxicity
- E) Electrolyte issue- CORRECT – K was 2.5
1-Minute Consult on this topic: Click HERE and scroll to hypokalemia
CASE CONCLUSION: Admitted
CASE LESSONS: