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.
When an acute inferior myocardial infarction is diagnosed, a right-sided ECG should be obtained to exclude the presence of a concomitant right ventricular myocardial infarction (RVMI). RVMIs can complicate 30% to 50% of acute IMIs.
The goal of a cardiac stress test is to identify the patient with obstructive coronary artery disease (CAD), typically defined as stenosis of 50% or more of a coronary artery on angiography.
VAD (Ventricular assist device) patients are a special challenge for the EP. Through a careful assessment of the VAD, physical exam, MAP, ECG, and echo, the EP can resuscitate the good VAD that has gone bad.
In 2009, “highly sensitive” troponin assays became available. These assays can detect the presence of troponin at much lower serum levels compared to traditional troponin assays. “Highly sensitive” troponins have a higher sensitivity and negative predictive value, but lower specificity, when compared with traditional troponin assays.
Ventricular tachycardia is a wide complex tachycardia (WCT) that is typically associated with coronary artery disease or other significant heart disease. The rapid rate, often in conjunction with poor baseline…
It can be especially difficult to distinguish between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with aberrant conduction. Fortunately, if the patient is unstable, the initial treatment for both rhythms is synchronized electrical cardioversion.
In 1930, Wolff, Parkinson, and White described the combination of bundlebranch block, shortened PR interval, and recurrent episodes of tachycardia that occurred in young, healthy patients with structurally normal hearts.…