Posts tagged cardiology
An Uncommon Cause of Shortness of Breath in the Emergency department: Acute Mitral Regurgitation
An Uncommon Cause of Shortness of Breath in the Emergency department: Acute Mitral Regurgitation

By: Russell Prichard MD and Melanie Lippman MD

CASE

The patient is a 52 year-old female with a past medical history of hypertension, hyperlipidemia, hypothyroidism, and a 2 pack a day smoking history who presented to the emergency department in respiratory distress.

When EMS arrived to the patient’s home, she was hypoxemic with a pulse oximetry reading of 70s on room air and hypotensive with systolic blood pressures in the 80s. She was placed on nasal cannula with improvement in her saturations and she was given aspirin, fentanyl, and nitroglycerin without relief.

Upon arrival her vitals were significant for respiratory rate of 34, pulse oximetry of 98% on 6L NC. She was noted to be in acute distress.

The patient was placed on positive pressure ventilation via BiPAP and broad blood work, chest X-ray and electrocardiogram (ECG) were obtained.

Read More
Critical Care, Community EM, Respiratory, Resuscitation, Ultrasound, CardiologyRussell Prichardcardiology, Critical Care, RespiratoryComment
ElectrocardioBrown: Posterior STEMI
ElectrocardioBrown: Posterior STEMI

A middle-aged male presented in cardiac arrest. He had reportedly complained of preceding chest pain. Upon EMS arrival, his presenting rhythm was ventricular fibrillation (VF), which was refractory to multiple attempts at defibrillation. After receiving treatment for refractory VF, the patient had return of spontaneous circulation (ROSC). He was hypotensive, and ultimately required triple pressor support to maintain adequate mean arterial pressure. An initial electrocardiogram (EKG) was performed, which showed sinus tachycardia. A repeat EKG was performed one hour later, showing…

Read More
CardiologyJoseph Moran-GuiatiEKG, STEMI, cardiology, posterior STEMI, ROSC, cardiac arrestComment