Amal Mattu’s ECG Case of the Week – January 12, 2015

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

Review Key Teaching Points

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.

By wpadmin|2016-12-21T17:14:59-05:00January 12th, 2015|7 Comments

7 Comments

Rick G January 16, 2015 at 6:21 pmLog in to Reply

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
Amal M January 19, 2015 at 5:34 pmLog in to Reply

Rick,
Thanks so much for your comments. Please stay in touch!
AM
David B January 24, 2015 at 9:13 amLog in to Reply

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!
Amal M January 27, 2015 at 3:56 pmLog in to Reply

David, That’s awesome…you made my day!
Our EKG nerd club continues to grow bigger!.
alaa n February 8, 2015 at 3:38 pmLog in to Reply

great work dr mattu ….. awesome EKG site ….. you are the EKG hero 🙂
alaa n February 8, 2015 at 3:44 pmLog in to Reply

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 ???
Stethoscope Nunchucks March 28, 2015 at 9:44 amLog in to Reply

Great case, thanks!