Cardiology/Vascular
Dangerous Dysrhythmias in the ED: An Interactive EKG Workshop for Emergency Medicine Clerkship Learners
DOI: https://doi.org/10.5070/M5.52195By the end of this session, learners will be able to: 1) identify common tachyarrhythmias and pulseless rhythms using EKGs, 2) differentiate stable from unstable tachyarrhythmias based on hemodynamics, symptoms, and EKG findings in acutely ill ED patients, 3) apply appropriate critical resuscitative actions to manage stable tachyarrhythmias, unstable tachyarrhythmias, and pulseless rhythms during emergency department resuscitations, in accordance with ACLS (Advanced Cardiopulmonary Life Support) principles, and 4) construct a rapid, ED-focused decision-making algorithm to guide the identification and management of tachyarrhythmias and pulseless rhythms.
ECG Bootcamp – A Novel Emergency Medicine Small Group Session
DOI: https://doi.org/10.5070/M5.52155By the end of this group exercise, learners will be able to: 1) Recognize an emergent ECG that needs action immediately, 2) Demonstrate an understanding of normal vs abnormal pediatric ECGs, 3) Identify ECG manifestations of toxicologic conditions, 4) Describe the key characteristics of an ECG in a patient with a pacemaker and problems thereof, 5) Compare and contrast common ECG findings in patients with certain congenital/hereditary cardiac conditions, 6) Manage a patient presenting in extremis with torsades de pointes in the emergency department.
Rapidly Progressive Painless Acute Aortic Dissection: A Case Report
DOI: https://doi.org/10.5070/M5.52348A POCUS of the abdomen at that time demonstrated findings concerning for a dissection flap in the abdominal aorta (green arrows), and a new mild to moderate pericardial effusion was seen on a repeat cardiac POCUS suggesting an evolving aortic dissection (blue arrows). The patient’s CTA revealed a type A AAD with extension from the aortic root to the bilateral external and internal iliac vessels as well as the coronary arteries (red arrows).
Computed Tomography Findings of Cerebral Venous Thrombosis: A Case Report
DOI: https://doi.org/10.5070/M5.52331The emergency physician ordered a non-contrast head CT and CT venogram of the head given worsening symptoms with disequilibrium and CVT risk factors of postpartum coagulopathy. The non-contrast head CT demonstrated a hyperdensity occlusion of the left transverse sinus (blue arrow). This serpiginous hyperdensity is called the “cord” or “string” sign, which is thrombosis within the vein. The CT venogram of the head demonstrated occlusion of the left transverse (red arrows) and sigmoid sinus (yellow arrow).
Enhancing Emergency Medicine Resident Education: A Weekly Education Series to Augment Electrocardiogram Education
DOI: https://doi.org/10.5070/M5.52141The goals of the curriculum were to establish an asynchronous ECG curriculum to help improve standardization of EM resident education, expose EM residents to a more comprehensive ECG curriculum, increase active learning in this arena, and decrease the administrative burden while not dedicating further conference time towards ECG education.
A Case Report of a 36-year-old Male Diagnosed with a Spontaneous Coronary Artery Dissection
DOI: https://doi.org/10.5070/M5.52022The initial ECG obtained from the patient shows subtle ST-segment elevation noted in leads I, aVL, and V2-V5, suggestive of pathology of the left anterior descending artery. The results of the catheterization revealed a spontaneous coronary artery dissection of the distal portion of the left anterior descending coronary artery, which can be seen in the image of the angiogram, with the diseased portion notated between the brackets.
Effects of Volume Overload: A Case Report of an Edema Bulla
DOI: https://doi.org/10.5070/M5.52206This image shows a large edema bulla on the patient's right shin. The bulla is 10 x 10 cm, filled with serous fluid, has a spontaneously occurring defect in the skin of the superior portion of the bulla, and is non-erythematous. The bulla is much larger than the 1-5 cm edema bullae described in the literature. As edema bulla is primarily a clinical diagnosis, taking the full history and physical exam into account is essential to recognize these bullae.
Reassessment Case: Acute Pulmonary Edema in a Boarding Patient
DOI: https://doi.org/10.21980/J8.52353By the end of the case, the learner should will be able to: 1) demonstrate competency with the new ABEM Certifying Exam Reassessment case format, 2) demonstrate the ability to evaluate new information and integrate it into an existing care plan, 3) recognize signs and symptoms of pulmonary edema, 4) review possible etiologies of acute respiratory distress and the evaluation/work up to differentiate and diagnose those causes, and 5) manage pulmonary edema including implementing afterload reduction, positive pressure ventilation, and diuresis.