Here is your quick guide to rate and rhythm control of atrial fibrillation with rapid ventricular response.

While the scuba diving decompression illnesses of decompression sickness and arterial gas embolism are treated the same, the pathophysiology and presentation are different.

A 76 year old female is brought to your ED by EMS on a hot summer day after she was found sitting in a wheelchair outside of her house..

Read on for a "can't-miss" diagnosis that should be on your differential for a child with prolonged (>/= 5 days) fever.

A 60-year-old man presents with chest pain. His EKG shows ST elevations in leads II, III and aVF as well as ST depressions in V2 and V3. A right-sided electrocardiogram is also performed and shows elevated ST segments in V4R and V5R. Which of the following medications is contraindicated? 

A. Aspirin

A 40 year old male with history of Marfan's Syndrome comes in with sudden onset shortness of breath preceded by tearing chest pain. He is tachycardic to 120, blood pressure is 80/40, patient is tachypneic with increased work of breathing. CXR is consistent with widened mediastinum and pulmonary edema and stat bedside ECHO is concerning for acute aortic regurgitation secondary to aortic insufficiency. Cardiothoracic surgery is consulted. What two medical modalities are contraindicated in this patient? 

A. Beta Blocker and Intra-Aortic Balloon Pump

68yo Male, hx DM (+insulin pump), CHF (+lasix), HTN, presents to the ED c/o intermittent episodes of lightheadedness for the past year, becoming more frequent over the past month and had an episode today while getting out of bed. No syncope. At home noted HR 33, went to urgent care, HR 37. Patient was sent to the ED for further evaluation. What did the ECG show?

Dr. Richard Byrne discussed a step-wise approach to treating and potentially discharging the patient in Afib with RVR.  Read ahead to review the approach:  

For the final week of our cardiology module, Dr. Lisa Filippone presented a great case.  A 24 y.o. male  playing basketball developed palpitations, lightheadedness, dizziness and almost 'passed out'.  On arrival to the ED the patient looked well and had no complaints except for palpitations:  HR 190, BP 130/70.  Lungs were clear, heart without an audible murmur and neuro exam was unremarkable.  ECG shown is shown.  What is the diagnosis and treatment?