HPI: 64-year-old male smoker with a Hx of HTN, DM, COPD presents with lightheadedness and chest tightness. He has had flu like symptoms for the past week, that have been getting progressively worse, with vomiting, dyspnea, and a syncopal episode. He thinks, “It’s my COPD”.
Vitals: HR-80s, BP-100/50, RR-24, SpO2-95%, afebrile.
Exam: Non-toxic, looks uncomfortable. Slight wheezing, regular heart rate with no m/r/g. Otherwise normal.
Case ECG
Before watching this week’s video, ask yourself these questions:
- What is your differential for this wide complex rhythm?
- Would you activate the cath lab based on this ECG?
Case Interpretation
Kudos:
Thanks to Dr. Jon Kenyon (Kaiser Permanente, San Francisco) for sending this weeks case!
Notes: Questions for Amal? Email him at amalmattu@comcast.net or find him on Twitter @amalmattu.
I have been following your teachings for for the past three years Doc. Phenominal is all I have to say. I teach pre-hospital care (Paramedicine) and I use your vidoes as a teaching tool. I can tell u the students benefit greatly and in turn their patients benefit. I know a great many of the students follow your presentations post graduation as well. Thank you. Rick
Rick,
Thanks so much for your comments. Please stay in touch!
AM
Thanks so much! The right axis pearl is great! I have watched you for years and you made me the hero of the hospital last week! In one day, I used T wave inversion anteroseptally and inferiorly to make a big PE call before the CT angio, and rescue another patient who had V tach that the nurses were calling SVT. Thanks again for making me an EKG nerd and helping patients!
David, That’s awesome…you made my day!
Our EKG nerd club continues to grow bigger!.
great work dr mattu ….. awesome EKG site ….. you are the EKG hero 🙂
the only indication of calcium in hyperkalemia is hyperkalemic emergency which is equal to WIDE QRS COMPLEX IN EKG “” i saw this in one of the presentations of Dr Corey Slovis,MD
and you learn us that hyperkalemia my presented by resistant bradycardia without wide ecg complex
in this case iv calcium is not indicated ???
Great case, thanks!