Tag Archive for: EKG of the Week

R.E.B.E.L. ECG of the Week #6

12 Dec
December 12, 2013

R.E.B.E.L. EM ECG of the Week #6The case from this week is from one of the PGY-1 residents at University of Texas Health Science Center at San Antonio (UTHSCSA).  Several of the details of the case have been changed to keep patient information confidential.

53 year old female with a past medical history of hypertension, hyperlipidemia, coronary artery disease, and 3 anterior myocardial infarctions s/p 4-vessel CABG (LIMA-LAD, RIMA-RCA, SVG-D1-OM1 sequentially) 9 months ago who presents with intermittent 10/10 chest pain that radiates to his left arm for the past 6 months. The chest pain is associated with nausea and shortness of breath but denies diaphoresis or syncope. Patient reports that the pain is the same as his index chest pain and is both exertional and non-exertional and will often wake him up from sleep. The pain can last 5-10 minutes and is always relieved by rest. The patient reports good medication compliance (on metoprolol, atorvastatin, enalapril, amlodipine, aspirin). He presented with similar symptoms 3 months ago but left against medical advice before a work-up could be performed. Now he presents with increasing frequency of chest pain.

BP 152/105  HR 86 RR 16 O2 sat 99% on RA   Temp 98.0

ECG from triage is shown… Read more →

R.E.B.E.L. ECG of the Week #5

04 Dec
December 4, 2013

R.E.B.E.L. EM ECG of the Week #555 year old male with chief complaint of palpitations.  Denies any chest pain, shortness of breath, diaphoresis, or syncope.  His past medical history is significant for diastolic congestive heart failure, type 2 diabetes mellitus, hypertension, and hyperlipidemia. Per patient he had a diagnosis of atrial fibrillation vs ventricular tachycardia 2 years prior, but he is unsure of which one exactly.

BP: 153/83     HR: 183     RR: 18     O2 on RA: 99%     Temp: 36.3

ECG from triage is shown… Read more →

R.E.B.E.L. ECG of the Week #4

29 Nov
November 29, 2013

R.E.B.E.L. EM ECG of the Week #462 year old male with chief complaint of weakness.  Patient had a complicated hospital course including necrotizing fasciitis which required surgical debridement and IV antibiotics.  Patient was discharged home with oral antibiotics and returned to the ED with a chief complaint of weakness, abdominal pain, and 3 weeks of loose bowel movements.

BP: 100/51     HR 93     RR 16     Temp 97.2     O2 Sat 98% on RA

ECG from triage is shown… Read more →

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

R.E.B.E.L. EM ECG of the Week #258 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…

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