Patient FC Flashcards
Patient presents in AE with sharp pain upon inhalation as well as shortness of breath. They have noticed blood in their sputum. ECG shows 120bpm and T wave inversion in leads II, III, and aVF.
Likely diagnosis?
Pulmonary embolism d/t resp symptoms as well as RH strain on ECG (RV dilatation and contractile and conductory dysfunction)
A 66-year-old farmer was admitted with 1-day history of acute-onset severe pleuritic chest pain, with four episodes lasting 10–15 min. The pain was worse when lying flat and relieved by leaning forward. He had no sweating nor fever. His history includes Crohn’s disease, hypertension and benign prostatic hyperplasia. On examination his temperature was 36.9°C, blood pressure was 134/83 mm Hg, heart rate was 86 beats/min, respiratory rate was 16 breaths/min and an O2 saturation of 99% on ambient air. His general, cardiovascular and respiratory examinations were normal.
CRP 7mg/L (abn., ++), ECG: PR depression, CXR: clear lungs, bright ECHO of pericardium
Likely dx? and therefore tx plan?
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437700/)
Differential diagnoses included myocarditis, acute coronary syndrome, pericarditis or pleuritis.
A diagnosis of pericarditis was made based on typical chest pain, ECG presentation and TTE. He was started on oral colchicine.
A patient presents in AE with what seems to be a suspected rapid onset AF. What is potential initial management plan?
(NICE: arrhythmias)
(1) emergency electrocardioversion in life-threatening emergency
(2) non-LT then rate or rhythm control
* AMIODARONE or FLECAINIDE (cardioversion - pharma)
* BB or VERAPAMIL (IV - urgent)
* if >48hr then electrical cardioversion
