A 66-year-old female with a past medical history of acute myeloid leukemia on chemotherapy complicated by tumor lysis syndrome and myelofibrosis presents for a concern of hypotension and tachycardia which was noted on presentation to the outpatient infusion clinic.  The patient states she has been feeling well and her last chemo was a month ago.  The patient denies any physical manifestations including shortness of breath, chest pain, nausea, vomiting, or other symptoms at present. She does have a history of supraventricular tachycardia (SVT). 

Erica Dolph MD and Ari Edelheit MD

A 25-year-old male with no medical history presents to the emergency department with intermittent chest pain and palpitations. The chest pain is not exertional, positional, or radiating and the patient denies shortness of breath or syncope. The patient does note palpitations associated with lightheadedness.. He denies family history of sudden cardiac deaths. Initial vital signs are notable for BP 129/58, HR 76, RR 18, and O2 saturation of 98% on room air. The patient’s initial EKG (Figure 1) is shown.

Abish Kharel MD and Ari Edelheit MD

A 60-year-old male with hypertension and diabetes presented to the emergency department for two hours of substernal chest pain radiating to his jaw. The EKG from triage (Figure 1) is brought to the emergency physician (EP) stat due to some subtle abnormalities. Based on this EKG what are your next steps? 

Michael Hohl MD and Ari Edelheit MD