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the County Consult

A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.

Figure 1. Index EKG

Heart of the Matter: Don't Forget to Look for the Delta

September 22, 2025

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

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In Cardiology Tags Cardiology
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Figure 1. Index EKG

Heart of the Matter: Posterior Leads for Posterior Ischemia

September 22, 2025

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

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In Cardiology Tags Cardiology
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Figure 1. Index EKG

Heart of the Matter: An Underappreciated Cause of OMI

August 14, 2025

A 34-year-old male with a history of heart failure with reduced ejection fraction of 20-25%, hypertension, and cocaine use disorder presented to the emergency department with leg swelling, cough with bloody sputum, and chest pain on exertion.

Michael Hohl MD and Ari Edelheit MD

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In Cardiology Tags Cardiology
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