Bradycardia is defined as a heart rate of less than 60 BPM. In the ED, we may not always have the time to stop to consider the etiology of bradycardia after we have stabilized our patient (and after we likely already consulted cardiology!) Having a thoughtful approach to the differential diagnosis for bradycardia can be extremely helpful in treating the underlying cause. The next time a bradycardic patient presents to your ED, think to yourself, “The Brady Bunch is on a DIET.”
You are evaluating a patient with the sudden onset of palpitations. You note a regular, narrow complex tachycardia at a rate of 160 bpm and suspect a reentrant tachycardia. You think "adenosine" but secretly wonder if there is a better option, or what you'll do if this fails....
For decades, Emergency Medicine Providers have struggled to come to a consensus on the management of patients with chest pain with non-ischemic ECGs and negative biomarker testing. Both cardiology and emergency medicine guidelines failed to provide a clear recommendation on which patients should be discharged from the ED. The American College of Emergency Physicians has taken a bold step with their latest guidelines for the management of low risk chest pain patients which will dramatically change standard practice in the care of possible ACS patients.
A 28-year old male with no past medical history presents with ches tpain for 2 days. The pain is pressure-like in the center of his ches tand worse with deep inspiration. He states he just got over a cold but denies recent fever or cough. An EKG is obtained. What is the diagnosis?