This is a tough one and congratulations to the thorough responders. This month’s winner – Dr. Nico Grundmann! To start, TCA ingestion is the most common cause of Na-channel toxicity that we see in ECGs – but this patient was…
47 year-old female with past medical history of depression and supraventricular tachycardia, brought in by EMS with altered mental status and found with empty pill bottles nearby. What is the interpretation of this ECG? What likely happened to this…
Excellent answer by Dr. Kylie Birnbaum! This patient indeed has a supraventricular tachycardia (SVT), and indeed was found to have fast-slow atrioventricular nodal re-entrant tachycardia (AVNRT) on later electrophysiologic study. In the ED at Janus General, however, vagal maneuvers failed…
80 yo F presents with intermittent palpitations associated with shortness of breath but is otherwise stable. What is your differential for this rhythm? How do you treat it? Best answer by Friday will win!
From the hand of Dr. Yonatan Yohannes… . This case puts the providers in a bit of a dilemma. The ECG is concerning for possible left main coronary artery (LMCA) or proximal left anterior descending (LAD) artery occlusion. However, the history…
This month we have a guest author Dr. Yonatan Yohannes! You are busy working late one night in the ED at Janus General when… a tech hands you the ECG shown below for a patient presenting with “chest pain”.…
Truly excellent interpretation by Dr. Joey Freedman. This is indeed a patient with rapid atrial fibrillation with aberrantly conducted complexes and intermittent biventricular pacing. Whew! Think of atrial fibrillation with rapid ventricular response, but the ventricles are unable to respond…
Over at Janus General, where I’m on staff, there is a … 60 yo M with SOB: What is this rhythm and how do you treat it? Best and most complete answer by 9/19/14 at noon will win!…