ECG Cases 35 – ECG Approach to Takotsubo Syndrome

Takotsubo Syndrome is usually triggered by an emotional or physical stress leading to acute catecholaminergic myocardial stunning. The initial ST elevation phase of Takotsubo Syndrome mimics Occlusion MI, can not be distinguished by patient factors or POCUS findings, and requires immediate angiogram. The subsequent phase of Takotsubo Syndrome has T wave inversion in an apical distribution, which can mimic reperfusion, but often has very deep T wave inversions and a very long QT interval. Takotsubo Syndrome is a retrospective diagnosis of exclusion—with an angiogram ruling out occlusion, a ventriculogram showing apical ballooning, and a follow up echo showing recovery of LV function. Complications of Takotsubo Syndrome include LV failure, apical thrombus, and polymorphic VT from long QT. Jesse McLaren guides us through 10 ECGs to elucidate these important take home points...

Episode 25: Pediatric Syncope and Adult Syncope

In this episode on Pediatric Syncope & Adult Syncope, Dr. Eric Letovksy & Dr. Anna Jarvis run through the key clinical pearls of the history, the physical, interpretation of the ECG and the value of clinical decision rules such as the ROSE rule and the San Francisco Syncope Rule in working up these patients. We discuss how to differentiate syncope from seizure, cardiac causes of syncope such as Arrhthmogenic Right Ventricular Cardiomyopthy & Prolonged QT Syndrome, and the indications for Holter monitoring, Echocardiograms and stress testing in patients with Syncope. Dr. Letvosky & Dr. Jarvis answer such questions as: How can we diagnose Hypertrophic Cardiomyopathy in the ED? What is the value of Troponin and BNP in the work-up of syncope? In what ways are patients with Down Syndrome at high risk for serious causes of syncope? In what ways are patients with alcohol dependence at risk for serious causes of syncope? Why is 'Benign' early repolarization not a benign condition in patients with syncope? Which children with syncope should be admitted? and many more....

Best Case Ever 10: Pediatric Syncope

Pediatric Syncope usually has a benign cause, but may be a warning for sudden death. As a bonus to Episode 25 on ‘Pediatric & Adult Syncope’ with Dr. Eric Letovsky and Dr. Anna Jarvis, 'Canada's mother of Pediatric Emergency Medicine', we have Dr. Jarvis’s Best Case Ever. In the related episode we will cover how to differentiate syncope from seizure, key historical and physical exam clues to determine a cause of syncope, ECG pearls of syncope causing cardiac conditions, from Congenital Prolonged QT Syndrome to Arrhythmogenic Right Ventricular Cardiomyopathy, the value of syncope decision rules such as the ROSE rule and the San Francisco Syncope Rule, the value of ancillary testing, including Holter monitoring, Echocardiograms and Stress Testing and much more...... [wpfilebase tag=file id=386 tpl=emc-play /] [wpfilebase tag=file id=387 tpl=emc-mp3 /]

Donate Subscribe
Go to Top