[Max Sobrero]

A 65 yo M with pmh DM, HTN, CKD is BIBEMS after roommate witnessed syncopal event x 2. Patient repeatedly denies this but admits he has been feeling “a little weaker” over the past several days. He otherwise denies fever, chills, n/v, CP, SOB, DOE, bloody stools/melena. He would like to go home as soon as possible but is willing to be evaluated by you.

VS 37C, 160/80, 110, 24, 95%RA

Appears slightly diaphoretic and a little pale but otherwise unrevealing exam.

What is your interpretation of his initial EKG? What are your next steps?

[amasingh@alamedahealthsystem.org]

A bunch of little things abnormal with this ECG

sinus tachycardia

S1Q3 with maybe a T3

STE in aVR and V1

mild diffuse STD in I, II, aVL, aVF, V3-V6

the R wave transition is early

and there is a PAC with normal conduction and a PAC with aberrant conduction

I vote PE – this ECG has 3 of the 5 common signs consistent with PE.

[Max Sobrero]

Thanks, Deep! Final chance for residents to chime in before the answer is revealed…

Anything else you’d want to know or do? How would you work this up?

Hint: Deep is *really* good at interpreting EKGs…

[overniushe]

Research paper writing is often a daunting task for students, and I can definitely relate. It can be overwhelming to sift through countless sources, analyze data, and then organize everything into a coherent paper. But it’s important to remember that you’re not alone in this struggle. BestCustomWriting is a research paper writing service every tired student can trust. Here you may not worry about the timely delivery, authentic content, and relevant sources used – expert writers know how to write research papers that get an A.

[Author]

Posts