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...
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.
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) 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.
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.
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).
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)
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.
Heart murmurs are due to vibrations caused by turbulent flow within the heart. The most common causes are due to left-sided valvular heart disease and tricuspid regurgitation.
Approximately 1% to 2% of patients with hypertension will present with a hypertensive emergency, defined as organ dysfunction due to an elevated blood pressure. Importantly, there is no specific blood pressure threshold that identifies a patient with a hypertensive emergency.