An 86-year-old female with a past medical history of “a murmur” presents to the Emergency Department (ED) with a complaint of dyspnea on exertion for the past 2 days. Her heart rate in triage is 150 beats per minute (bpm), so she is immediately roomed in the resuscitation bay. An ECG is obtained, which demonstrates atrial fibrillation with rapid ventricular rate (RVR). The patient is started on appropriate treatment in consultation with Cardiology when the telemetry monitor begins to alarm. A repeat ECG is obtained.
Michael Hohl, MD and Ari Edelheit, MD
Read MoreA 74-year-old female with a past medical history of hypertension, diabetes, hyperlipidemia, and tobacco use disorder presents with chest discomfort and indigestion ongoing for the past 2 weeks. She reports radiation to the jaw and left upper extremity. Recently, she has been feeling short of breath and has experienced some exercise intolerance, limiting her mobility to just half a block, which she partially attributes to her osteoarthritis. She has been compliant with her home medications, which include antihypertensives, metformin, and a statin. On presentation at rest, her pain is less than it has been in the last couple weeks but is still present. An ECG is obtained (Figure 1).
Lucas Ferreira, MD and Ari Edelheit, MD
Read MoreYou receive a call from the lab for a critical result; your patient has a potassium of 6.0. You order an ECG and then look around for an attending for help. Should you just give the patient sodium zirconium cyclosilicate (commercially known as Lokelma), or should you throw the kitchen sink at the patient? Are those T waves peaked? Panic no longer - let’s talk hyperkalemia.
Samson Frendo, MD and Eric Leser, MD
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