History:
A patient in their mid-60’s with a history of DM, HTN and lung CA is transported from home to the ER for generalized weakness. He was found by medics to be in a-fib in the 180’s with a BP in the low 60’s. They sedated him with Versed 5mg and cardioverted to sinus tach at 120 with BP improving to the low 90’s. They gave IV fluids and the BP went up to the high 90’s
Exam:
Lethargic but just got Ativan. Tongue is dry. Improving per medics. Tachycardic
An ECG is done
Computer Read: ST at 116, ST and TWA consider lateral and inferior ischemia
What is the most cause of EKG findings in this patient?
- A) Acute coronary occlusion
- B) Blood clot (PE)
- C) Cardiac tamponade
- D) Drug toxicity
- E) Electrolyte issue
SCROLL DOWN FOR THE EKG ANALYSIS & 1-MINUTE CONSULT
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THE EMERGENCY MEDICINE POCKETBOOK TRIFECTA
Emergency Medicine 1-Minute Consult, 5th edition
A-to-Z EM Pharmacopoeia & Antibiotic Guide, NEW 5th edition
8-in-1 Emergency Department Quick Reference, NEW 5th edition
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ECG interpretation:
QUIZ ANSWER:
- A) Acute coronary occlusion – good thought but changes are diffuse
- B) Blood clot (PE) – good thought as has cancer
- C) Cardiac tamponade – tachycardia fits but voltages are not low
- D) Drug toxicity – good thought
- E) Electrolyte issue – CORRECT – tachycardia from dehydration and diffused ST depression from low K, which can also cause the initial a-fib
Case Outcome: K 2.3, Mg 1.4
for the Emergency Medicine 1-Minute Consult: Click HERE and scroll to proper area.
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