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David Didlake EMT-P, RN, ACNP @DidlakeDW An adult male self-presented to the ED with palpitations and the following ECG. The patient was very uncomfortable, dyspneic, and displayed an SpO2 90% on RA. He denied any known history of CAD, but did report ASCVD risk factors to include HTN, HLD, and DM. Of interest, he specified that he awoke earlier that morning in his usual state of health, then developed chest discomfort, then developed palpitations.
Written by Pendell Meyers A man in his 70s presented with history of pacemaker presented with shortness of breath with exertion and presyncope. Here is his triage ECG with minimal symptoms: What do you think? The ECG shows pacemaker failure with inability to capture or sense, with either underlying atrial fibrillation or junctional escape rhythm. The QRS shows LVH and there are diffuse ST-T abnormalities likely in part appropriate for the LVH, though memory T waves are also a consideration.
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