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