Intro We had an awesome lecture by Dr. K Gore this past week–this blog is a quick review of her lecture on aortic dissection. Background An aortic dissection (AD) is a tear into the intimal layer of the aortic wall. It is commonly described as a “tearing” chest pain that radiates to the back–which is…
Author: Dr. Catherine Buckley
When I think of patients with valvular disease in the setting of the emergency department, it is frequently the acute on chronic picture. For instance: the Aortic stenosis patient with significant worsening of their fluid overload symptoms because of sepsis. What I typically don’t imagine is diagnosing or treating brand new valvular emergencies. Thank goodness for didactics! We are going to briefly review acute Mitral Regurgitation and acute Aortic regurgitation based on a wonderful talk given by Dr. Yelena Dukarevich.
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Author: Dr. Catherine Buckley
Alright. LVADs. First thing is first- use a lifeline and phone a friend. Call the patient’s VAD coordinator. Patient may have a card that they are able to give you… but if the patient is otherwise incapacitated, look for a tag on their controller.
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Intro
There’s an old adage that wide complex tachycardia is VTach until proven otherwise. While this is true as do not want to miss any potentially lethal arrhythmia, it is also important to understand the differential for wide complex tachycardias so that we can tailor our potential treatments to the specific arrhythmia. It is also important to note that in any unstable patient with a wide complex tachycardia (or narrow complex tachycardia) that electricity is always safe.
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Intro
The differential for narrow complex tachycardia is extremely important as it is the most commonly seen abnormal EKG in the emergency department. It includes rhythms such as sinus tachycardia, AVnRT, AVRT, atrial flutter, ectopic atrial tachycardia (EAT), atrial fibrillation, atrial flutter, and multifocal atrial tachycardia (MAT).
The goal of this blog is to run through this differential and give some methods to differentiate the rhythms. Although we will not delve too deep into antiarrhythmics, it is important to note that electricity is safe in all unstable rhythms no matter the etiology.
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Dr. Patwari did a great review on differentiating ST elevations associated with pericarditis vs. acute MI. From medical school, I think we can recall many of the classic EKG findings that support pericarditis Diffuse ST elevations Concave upwards STE PR depressions in multiple leads (only reliable seen in viral pericarditis) PR elevation in aVR However,…
Last week’s 5-minute EKG discussion was lead by our APD, Dr. Scott Heinrich.
You get handed this EKG from a patient in triage with chest pain. Should you activate the cath lab?
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Pacemakers are becoming increasingly common as our population ages, and are seen more and more in the emergency department. The goal of this post is to summarize common pacemaker settings, the 5-letter nomenclature of pacemakers, indications for pacemaker placement, pacemaker components, common pacemaker complications (majority of blog), and lastly the management of pacemakers in the ED (including applying a magnet). …And as always, the blog ends with some medical history
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NSTEMI, STEMI, ACS
Author: Catherine Buckley MD There are about 8 – 10 million ED visits with the chief complaint of chest pain per year in the US. (Owens et al.)10 billion dollars are spent on chest pain, 10% of which goes to the work up for ACS diagnosis. Yet somehow despite these millions we still miss 1-2%…
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