Archive for category: ECG

R.E.B.E.L. ECG of the Week #3

18 Nov
November 18, 2013

R.E.B.E.L. EM ECG of the Week #3The subject of this ECG of the Week is a 47 y/o hispanic female with a past medical history of type 2 diabetes mellitus, hypertension, hyperlipidemia, and morbid obesity with a chief complaint of weakness.  Per the patient she cleans houses for a living and for the past 2 weeks she gets weak and short of breath earlier in the day while cleaning houses.  She used to be able to clean all day without issues, but for the past 2 weeks this has been getting less and less.  No chest pain, vomiting, diaphoresis, or syncope.  She has never had anything like this before.  She comes to the ER today because this is her only day off.  She has not had any symptoms today.

BP 156/94  HR 68 RR 14 O2 sat 100% on RA   Temp 98.7

ECG from triage is shown…

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R.E.B.E.L. ECG of the Week #2

11 Nov
November 11, 2013

58 year old female with chief complaint of chest pain x2hours with PMH of type 2 diabetes mellitus, Hyperlipidemia, and hypertension.    She is brought in via EMS still having active chest pain. BP: 102/88  HR: 82  RR: 24  O2 Sat on 2L: 99%  Temp 99.0 ECG obtained at arrival is shown…

R.E.B.E.L. ECG of the Week #1

08 Nov
November 8, 2013

68 year old hispanic female with a chief complaint of weakness/syncope.  PMH of type 2 diabetes mellitus and hypertension.  She was brought in via EMS due to the family calling 911 as she had an episode of syncope while at the dinner table.  At the time of arrival: VS: 96/48   43     18 […]

Bundle Branch Blocks: 101

01 Nov
November 1, 2013

Recently, I have been asked by several students at my home institution (UTHSC at San Antonio) to help them understand bundle branch blocks.  This is different than some of my usual posts because it is meant to be more educational than evidence based.  So here we go.  The normal conduction system of the healthy heart […]

The Importance of Reciprocal Changes in aVL

01 Nov
November 1, 2013

ECG interpretation is one of the most important skills to master as an emergency  physician, and its interpretation can be very complex and frustrating. ECG manifestations can be very subtle, and sometimes the earliest and only ECG change seen will be reciprocal changes alone. To further complicate this, many patients have the atypical symptoms of […]

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