Patwari Academy: ECG Rate, Rhythm, Axis

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Dr. Rahul Patwari reviews the basics on how to determine an ECG’s rate, rhythm, and axis. It’s always nice to review these concepts. Do you remember how many seconds a traditional ECG typically spans on a single page? What’s the significance of the numbers: 300, 150, 100, 75, 60, 50? Spend a few minutes on these 2 refresher videos.
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2019-01-28T21:57:46-08:00

EKG Subtlety: Tall T-Wave in Lead V1

Balance

EKGs are a simple, cheap modality that can give an emergency physician quite a bit of information.  Sometimes, in a busy ER, this information can be very subtle and almost overlooked without a second thought. A perfect example of this is a New Tall T-wave in  lead V1 (NTTV1). This finding can be a normal variant, but can also be a precursor to badness.

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2019-09-10T13:37:03-07:00

Takotsubo Cardiomyopathy: The Octopus Trap

Cartoon of Takotsubo CMTakotsubo Cardiomyopathy was first described in Japan in 1990 and  in the United States in 1998. It was named after an octopus trap (“tako-tsubo”) due to the shape of the trap being similar to the appearance of the left ventricular (LV) apical ballooning that occurs in this condition.  Why is this condition so important to know? It can mimic acute coronary syndrome and most patients go to the emergency department because they are worried they are having an acute myocardial infarction.

 

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2019-09-10T13:39:35-07:00

The Importance of Reciprocal Changes in Lead aVL

Reciprocal Change in aVL

ECG interpretation is one of the most important skills to master as an emergency  physician, and its interpretation can be very complex and frustrating. ECG manifestations can be very subtle, and sometimes the earliest and only ECG change seen will be reciprocal changes alone. To further complicate this, many patients have the atypical symptoms of nausea/vomiting, weakness, or shortness of breath and not chest pain.

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2019-09-10T13:39:23-07:00

Brugada Syndrome: An ECG Pattern You Need to Know

Brugada Syndrome

Brugada Syndrome is an abnormal ECG (Right Bundle Branch Block Pattern with coved ST elevation over the right precordial leads of V1-V3), which leads to ventricular fibrillation (VF) and sudden cardiac death (SCD) in patients with structurally normal hearts. It has been recognized as a clinical entity since 1992. Why should all ED physicians know about this entity? Although a rare syndrome, it is often mistaken as a STEMI and more importantly the clinical spectrum can be asymptomatic to SCD.

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2019-11-24T14:50:26-08:00