Examining and Investigating the Patient with Hypertension
Causes and mechanism of Hypertension
Approximately 95% of all patient with hypertension have "essential" or "primary" hypertension and have no underlying disease...
Chronic Heart Failure: Approach, Evaluation and Management
Symptoms and Sign of Chronic Heart Failure
Heart failure occurs when the heart is unable to maintain sufficient cardiac output to meet the demands of the body, despite the presence of normal filling pressures.
Left Ventricular Hypertrophy (LVH): How to Recognize it on ECG [With Examples]
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Major ECG findings induced by left ventricular hypertrophy (LVH)
Left Ventricular Hypertrophy (LVH) causes tall R waves in left sided and deep S waves in right sided leads. Always look for ‘strain’ pattern in left sided leads...
Atrial Flutter: ECG Interpretation [With Examples]
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Atrial Flutter with 4-1 AV Block
Characteristic features of Atrial Flutter are: Atrial rate around 300/min; ‘Sawtooth’ baseline; AV block (commonly 2:1, but can be 3:1, 4:1 or variable). You should always suspect atrial flutter with 2:1 block when a patient has a regular tachycardia with a ventricular rate of about 150/min.
Pearls in Syncope ECG Interpretation
Abnormal Ecg Findings of Cardiac Syncope
In the ED patient with syncope, the ECG should be scrutinized for signs of ischemia, bradydysrhythmias, tachydysrhythmias, and conduction delays. Critical diagnoses to consider that can be detected with the ECG include: Brugada syndrome, Long or short QT syndromes ...
Shortness of Breath (Dyspnea): Differential Diagnosis, Examination and Investigations
The Causes of Shortness of Breath (Dyspnea)
Shortness of breath (dyspnea) is the subjective sensation of breathlessness which is excessive for any given level of activity. It is important to remember that any component of the respiratory system can cause dyspnea.
Beyond Diuresis – Treatment Adjuncts in Cardiogenic Pulmonary Edema
The emergency management of patients with cardiogenic shock, acute pulmonary edema, or both
Diuretics may not be the preferred initial therapy, however, for those patients with vascular failure, who are often euvolemic, or those with cardiogenic shock, who are often hypovolemic. In these patients, the emergency provider should first optimize preload and afterload reduction with the use of noninvasive positive pressure ventilation (NPPV), nitrates, or inotropes as indicated.
Palpitations – Differential Diagnosis, Examination and Investigations
Algorithm for the investigation of the patient with palpitations
Always check what the patient means by "palpitations" or clarify what you mean, as the word means different things to different people. It is usually understood as an awareness of the heartbeat. The most common cause is an arrhythmia, although other causes include conditions causing an increase in stroke volume (e.g., regurgitant valvular disease) or conditions causing an increase in cardiac output, often noncardiac causes (e.g., exercise, thyrotoxicosis, anemia, or anxiety).
Aggressive Nitroglycerin Usage in Acute Decompensated Heart Failure (ADHF)
Phenotypes of Acute Decompensated Heart Failure (ADHF), their Presentations, and Suggested Therapy
In recent years, there are increasing data that support the use of high-dose vasodilator therapy as the initial treatment for patients with acute decompensated heart failure (ADHF)
Know the Differential for ST Segment Elevation: It’s More Than Just ACS
ST Segment Elevation - Differential Diagnosis
There are numerous conditions that cause ST-segment elevation (STE) on an ECG that are not attributable to an acute coronary syndrome. In order to avoid errors in diagnosis or management, it is important for the EP to know the differential diagnosis for STE.