If you didn't find what you were looking for, try a new search!
In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. They explain complementary diagnostic insights into pericardial effusion and cardiac tamponade, occlusion MI and RV strain...
In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life...
Dr. Jesse McLaren discusses some key aspects of cocaine chest pain ECG interpretation in this month's blog including: Patients with cocaine-associated chest pain require benzodiazepines +/- nitroglycerine for symptom relief, aspirin and ECG to look for signs of occlusion and reperfusion. In patients with chest pain + ST elevation, consider false positive STEMI including early repolarization, LVH and Brugada-pattern. In patients with cocaine chest pain who are STEMI negative, beware STEMI(-)OMI including subtle ST elevation, hyperacute T waves, reciprocal change, and refractory ischemia. For cocaine chest pain patients who's chest pain has resolved, look for reperfusion T wave inversion, as this may put them at risk for reocclusion.
In this month's EM Quick Hits podcast: Justin Morgenstern on the evidence for NG tubes in SBO, Jesse MacLaren on recognition of hyperacute T-waves vs other causes of tall T-waves, Brit Long on malignant otitis externa clinical pearls, Salim Rezaie on the value of CCTA in NSTEMI, Justin Morgenstern on the value of CCTA in low-risk chest pain, Hans Rosenberg on how to use the Canadian Syncope Score and it's validation in Canada...
In the age of high sensitivity troponins and the HEART pathway, which patients are safe to discharge home from the ED? What are the most useful historical factors to increase and decrease your pretest probability for ACS? Which cardiac risk factors have predictive value for ACS? Why should the words "troponitis" and "troponemia" be banned? How should high sensitivity troponin be interpreted differently than conventional troponin? Which is better for delta troponin interpretation - an absolute change in troponin or a percentage change? Which delta troponin is best - 1hr, 2hr or 3hr? What are the limitations of the HEART pathway? and many more....
In this ECG Cases blog with Dr. Jesse McLaren we interpret 10 ECG cases and explore cardiac, metabolic and GI causes: We consider anginal equivalents, and look for ECG signs of Occlusion MI, including subacute occlusion from delayed presentations. We consider electrolyte disturbances and look for ECG signs of hyperkalemia or hypokalemia/hypomagnesemia, and we consider the differential of diffuse ST depression with reciprocal ST elevation in aVR, and false positive STEMI...
Sickle Cell Acute Chest Syndrome remains the leading cause of death in patients suffering from Sickle Cell Disease. In his Best Case Ever, Dr. Richard Ward, a hematologist with a special interest in Sickle Cell Disease, describes a case of a Sickle Cell Disease patient who presents with what appears to be a simple pain crisis, but turns out to be a devastating Acute Chest Syndrome. He gives us the key clinical pearls and pitfalls to make this often elusive diagnosis early so that life-saving treatment can be initiated in a timely manner. This is in anticipation of the upcoming episode on The Emergency Management of Sickle Cell Pain Crisis with Dr. Ward and Dr. John Foote.
Jesse McLaren guides us through 9 cases and explains how pericarditis is a diagnosis of exclusion through 3 simple steps: 1. Exclude more serious causes of chest pain, eg wraparound LAD occlusion, inferior OMI 2. Exclude complications of pericarditis, eg myocarditis, large pericardial effusion 3. Exclude normal variant ST elevation presenting with benign chest pain on this month's ECG Cases blog...
In this ECG Cases blog we present ECGs from 7 patients who presented with chest pain and mild anterior ST elevation. Can you identify which were early repolarization and which were anterior STEMI?
In EM Cases' first ECG Cases blog we review 7 examples of ECGs of patients presenting to the ED with chest pain, who's ECG were read as normal by the computer. And guess what...they all show acute ischemia!