ECG Cases 43 – ECG Interpretation in Shortness of Breath

In this ECG Cases blog we look at 10 patients with shortness of breath, and discuss how the ECG can be used to help diagnose cardiac, respiratory and metabolic emergencies. We discover that for STEMI/OMI vs subendocardial ischemia, we should look for STEMI(-)OMI, subacute OMI, and OMI in the presence of LBBB and RBBB, and consider the differential for diffuse ST depression with reciprocal ST elevation in aVR. For RV strain, acute vs chronic, we should look for signs of acute RV strain and chronic pulmonary hypertension. for low voltages we should consider pericardial effusion and other causes, and for hyperkalemia we should look for multiple signs of hyperkalemia as a guide for empiric calcium...

EM Quick Hits 39 Overdiagnosis, Lytics for Submassive PE, Pericardial Effusion, Hemophilia Treatment

In this month's EM Quick Hits podcast Justin Morgenstern & Eddy Lang discuss the problem of overdiagnosis in EM, Anand Swaminathan's approach to indications and dosing of thrombolytics for submassive (intermediate risk) pulmonary embolism, Tahara Bhate's QI Corner on a patient with unexplained shortness of breath, Brit Long on emergency treatment of the bleeding hemophilia patient...

Ep 167 Myocarditis – A Diagnostic Challenge

Why does myocarditis often present a diagnostic challenge? What are the range of ECG findings in myocarditis? Does a negative high sensitivity troponin or CRP rule out myocarditis? What is the role of PoCUS in the diagnosis and prognosis of myocarditis? When should we consider myocarditis or pericarditis in patients with recent COVID-19 infection or COVID mRNA vaccination, and which of these patients require workups? Anton joins Dr. Paul Dorian and Dr. Walter Himmel to answer these and more...

ECG Cases 27 Pericarditis – Diagnosis of Exclusion

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...

EMU365 Amal Mattu on Killer ECGs and Pericardial Effusions

This EMU365 video features EM cardiology guru Dr. Amal Mattu on killer ECGs associated with pericardial effusions. He eloquently explains the utility of electrical alternans, specific lead and voltage criteria required to make the diagnosis of low voltage and more...

Episode 18 Part 1: Point of Care Ultrasound Pearls, Pitfalls and Controversies

In this first installment of this Episode, Point of Care Ultrasound Pearls, Pitfalls & Controversies we have a panel of POCUS gurus, Dr. Greg Hall, Dr. Jordan Chenkin, Dr. Paul Hannam & Dr. Jason Fischer. They review the basic criteria for commonly used, practical Point of Care Ultrasound indications at the bedside and then dive into heated debate about specific pearls and pitfalls in Point of Care Ultrasound assessment of the patient with undifferentiated shortness of breath, undifferentiated shock, cardiac arrest and swollen leg. They discuss how best to interpret the massive body of literature for POCUS and when we can hang our hats on our Point of Care Ultrasound findings.

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