thebluntdissection

pulling apart cases from the ED...

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  • February 23, 2019

faster than most…

May 1, 2014 by Christopher Partyka 5 Comments

the case.

a 34 year old man presents to ED with chest pain & palpitations. His symptoms came on suddenly whilst doing light exercises at the gym. [Read more…]

Filed Under: #FOAM, Cardiology, ECG Tagged With: broad complex tachycardia, ventricular flutter, ventricular tachycardia

palpitations & presyncope…

August 20, 2013 by Christopher Partyka 1 Comment

the case.

A 54 year old female presents to ED with an ‘odd sensation’ in her chest. This has been occurring intermittently for 2 months but has now increased in frequency & severity. She reports 3 episodes earlier today associated with nausea, clamminess & presyncope. [Read more…]

Filed Under: Cardiology, ECG Tagged With: arrhythmogenic right ventricle, ARVD, broad complex tachycardia, ECG, inferior axis, LBBB, monomorphic VT, palpitations, right ventricular outflow tract, RVOT VT, ventricular tachycardia

broad, fast & regular…

September 15, 2012 by Christopher Partyka 3 Comments

There are some things in medicine that I feel require a standardized approach for rapid diagnosis & management, especially in the face of an unstable patient & you have a little sweat on your brow. The following are two somewhat straight forward cases that got me thinking …

Case 1

66 year old self presents to ED following 4 hours of palpitations. She has had no chest pain, dyspnoea or pre-syncope. She has had this before.

HR 170. BP 128 systolic. Speaking full sentences with a clear chest. Sats 98%.

This is her ECG…

Image

Case 2: 

84 year old transferred to ED from the dialysis suite with 30mins of palpitations that commenced towards the end of his haemodialysis. He has no chest pain, dyspnoea or pre-syncope. He has had this before.

HR 160. BP 118 systolic. Speaking in phrases but clear chest. He looks grey & slightly clammy.

This is his ECG…

Image

… both are broad, fast & regular leading me to investigate “Ventricular Tachycardia vs SVT with Aberrancy”

[Read more…]

Filed Under: #FOAM, Cardiology, ECG Tagged With: broad complex tachycardia, ECG, SVT with aberrancy, ventricular tachycardia, VT

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