Cardiovascular
ECG Cases 39 – Transient STEMI Pitfalls and Pearls
In this ECG Cases blog we look at 9 patients with possible transient STEMI and discuss pitfalls and pearls in ECG interpretation and management...
ECG Cases 38 – ECG Interpretation in Cocaine Chest Pain
Dr. Jesse McLaren discusses some key aspects of cocaine chest pain ECG interpretation in this month's blog including: Patients with cocaine-associated chest pain require benzodiazepines +/- nitroglycerine for symptom relief, aspirin and ECG to look for signs of occlusion and reperfusion. In patients with chest pain + ST elevation, consider false positive STEMI including early repolarization, LVH and Brugada-pattern. In patients with cocaine chest pain who are STEMI negative, beware STEMI(-)OMI including subtle ST elevation, hyperacute T waves, reciprocal change, and refractory ischemia. For cocaine chest pain patients who's chest pain has resolved, look for reperfusion T wave inversion, as this may put them at risk for reocclusion.
EM Quick Hits 44 Fluids in Pancreatitis, Nasal Fractures, Delirium, DOSE VF, Intimate Partner Violence
In this EM Quick Hits podcast: Justin Morgenstern on fluids in pancreatitis, Leeor Sommer on nasal fractures, Christina Shenvi on delirium, Sheldon Cheskes and Rohit Mohindra on Dose VF, and Noor Khatib and Kari Sampsel on intimate partner violence...
ECG Cases 37 ECG interpretation in electrolyte emergencies
While most of us have a clear algorithm in our minds for the management of life-threatening hyperkalemia, the same may not be said about the other life-threatening electrolyte abnormalities. In this ECG Cases blog Dr. Jesse MacLaren gives us an approach to potassium, calcium and magnesium abnormalities including risk factor assessment, ECG interpretation and management pearls...
EM Quick Hits 43 Pediatric Cannabis Poisoning, Esophageal Perforation, Brugada, Career Transitions in EM
On this month's EM Quick Hits podcast: Best of University of Toronto EM with Yaron Finkelstein on pediatric cannabis poisoning pitfalls, Brit Long on recognition and management of esophageal perforation, Jesse McLaren on 3 questions to diagnose Brugada Syndrome, Tahara Bhate on QI Corner, Constance Leblanc on maintaining wellness in career transitions from CAEP 2022...
ECG Cases 36 – PACER Mnemonic for Approach to Pacemaker Patients
In this month's ECG Cases blog Dr. McLaren explains the PACER mnemonic approach to patients with pacemakers: Pacemaker spike: is it appropriately presence/absent, is there pacemaker-mediated tachycardia (apply magnet) or is there failure to pace (apply magnet to stop sensing, cardio consult)? Aware (sensing): is it normal, is there oversensing (underpacing: apply magnet) or undersensing (treat reversible causes, cardio consult). Capture: if there are pacemaker spikes is there capture, or failure to capture (treat reversible causes, cardio consult). ECG 12 lead: are there signs of hyperkalemia (extra wide QRS, peaked T) or Occlusion MI (Modified Sgarbossa Criteria) that need immediate treatment. Rest of patient: is there a complication of pacemaker insertion related to the pocket (hematoma, infection), lead (pneumothorax, DVT), or heart (pericardial perforation), or is there an emergency unrelated to the pacemaker (eg dehydration, sepsis, GI bleed)...
