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the County Consult

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

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Pharm & Cheese: A Shocking Case

November 19, 2025

We start this lovely Wednesday with EMS bringing in a 70-year-old man who just had a v-fib/v-tach arrest. After 5 rounds of CPR, 4 shocks, and 3 doses of epi, they’ve got him back! You prep airway equipment and the ultrasound, and in a few minutes, the patient arrives. 

Samson Frendo MD and Eric Leser MD

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In Cardiology, Critical Care Tags Critical Care, Cardiology
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Figure 1. Index EKG

Heart of the Matter: Dextrocardia

November 19, 2025

The patient is a 46 year old female who is presenting for concern of epigastric pain, nausea and vomiting. The patient has a history of chronic nausea, bipolar disorder, diabetes on insulin, and gastroparesis. Given her age and chief complaint, an EKG (Figure 1) was ordered to rule out atypical ACS.

Erica Dolph MD and Ari Edelheit

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In Cardiology Tags Cardiology
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Pharm & Cheese: A Haunting Wall Motion Abnormality, Beware of the Pumpkin Sign

October 23, 2025

Okay team, with spooky season in full swing, let’s talk about some scary stuff . . . chest pain. You’re on red team and they’ve just roomed a 54 year old female with a history of HTN presenting with acute onset chest pain immediately after hearing news that her brother had died, about 30 minutes prior to arrival. The pain is substernal, non-radiating, and described as “pressure-like”. Her systolic BP is in the 150s, but the rest of her vitals are normal. She appears distraught and in pain, but the rest of her exam is unrevealing.

Samson Frendo MD and Eric Leser MD

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