Pacemarker clinical

Pacemaker
There are different types of cardiac pacemakers.
Here we see a pacemaker with one lead in the

Pacemaker There ... types of cardiac pacemakers ... Here we see a pacemaker ... #Clinical #Radiology ... Biventricular #PPM #Pacemaker

Differentiating Pacemaker vs ICD on Chest XRay
- Single Chamber PPM
- Single Chamber ICD
-

Differentiating Pacemaker ... KhurrumKhanMD #Pacemaker ... Radiology #comparison #clinical

Comparison between Wandering atrial pacemaker (A) vs multifocal atrial arrhythmia (B)

#WAP #MAR #wandering #atrial #pacemaker #comparison

Wandering atrial pacemaker ... wandering #atrial #pacemaker ... electrocardiogram #clinical

Wandering Atrial Pacemaker ... #Clinical #Cardiology

Pacemaker Pocket ... Infection #Clinical ... #Photo #PPM #Pacemaker

Pacemaker Wire RV Perforation on POCUS Echocardiogram
Check out this clip of an elderly patient with a

Pacemaker Wire RV ... with a recent pacemaker ... KPSono @KpSono #Pacemaker ... Echocardiogram #clinical

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Pacemaker Operating Modes
1 - Chamber paced
A (atrium), V (ventricle), D (dual/both)
2

Pacemaker Operating ... response has no clinical ... period of time the pacemaker ... would trigger pacemaker-mediated ... The voltage the pacemaker

Pacemaker Wire on POCUS

Cool image - This was an older patient who was in a

Pacemaker Wire on ... the patient's pacemaker ... @eabramsMD #Pacemaker ... Echocardiogram #Clinical

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Wandering Atrial Pacemaker ... #Clinical #Cardiology

The 4 Variants of Sinus Arrhythmia
Phasic Sinus Arrhythmia:
• The rate increases with respiration and decreases

Wandering Atrial Pacemaker ... several cycle the pacemaker ... electrocardiogram #variants #clinical

Pacemaker Wire and Thrombus on POCUS Echocardiogram (A4c)
Look out for boogers floating on your pacer wires

Pacemaker Wire and ... @CincySono #Pacemaker ... A4c #cardiology #clinical

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A wandering atrial pacemaker, (WAP), is an atrial arrhythmia that occurs when the natural cardiac pacemaker

wandering atrial pacemaker ... natural cardiac pacemaker ... shifting of the pacemaker ... #Clinical #MedStudent

Point of Care Ultrasound for confirmation of transvenous pacing wire in right ventricle

Dr. J. Christian Fox

jchristianfox #Pacemaker ... #Confirmation #clinical

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Wandering Atrial Pacemaker ... several cycle the pacemaker ... electrocardiogram #variants #clinical

Pacemaker Operating ... response has no clinical ... EricsMedicalLectures/featured #Pacemaker

A junctional escape beat is a delayed heartbeat originating not from the atrium but from an

longer handling the pacemaker ... can take over pacemaker ... #Clinical #MedStudent

Pocket Hematoma after Pacemaker Placement
A rare, but can't-miss complication from pacemaker placement. Low incidence (1-9%) overall,

Hematoma after Pacemaker ... complication from pacemaker ... Pocket #Hematoma #clinical ... #Pacemaker #photo

Pacemaker Evaluation Algorithm by Lorne Costello

#Diagnosis #ECG #EKG #Pacemaker #Evaluation #Algorithm #PPM

Pacemaker Evaluation ... Diagnosis #ECG #EKG #Pacemaker

Atrioventricular Blocks (AV blocks) - ECG Diagnosis Summary
First Degree AV Block
• The P wave is

• This is a clinically ... by a junctional pacemaker ... an infra-Hisian pacemaker

Pacemaker Identification Algorithm

For more assistance check out this free application that uses AI to identify from

Pacemaker Identification ... camera screenshot: Pacemaker-I‪D ... apps.apple.com/us/app/pacemaker-id ... id1455009191 Which Pacemaker ... CXR #ChestXRay #Pacemaker

Pacemaker Complications
• Implantation-Related: Pocket hematoma, Infection (pocket), Pneumothorax, Hemothorax, Lead dislodgement, Cardiac perforation / tamponade

Pacemaker Complications ... cardiomyopathy, Pacemaker ... syndrome, Pacemaker-mediated ... /EricsMedi #Pacemaker

Pacemaker Coding Terminology
#Diagnosis #Cardiology #PPM #Pacemaker #LetterCode #Coding #Classification #Table #CoreEM

Pacemaker Coding ... Cardiology #PPM #Pacemaker

RV wall perforation from pacer wire on POCUS

Patient with severe chest pain since last night. SC

perforation #wall #PPM #Pacemaker ... echocardiogram #clinical

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Giant dilated left atrium on Echocardiogram (a4c)
It belongs to a 92-year old lady with a history

hypertension and a pacemaker ... Echocardiogram #clinical

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Transcutaneous #Pacer #Pacemarker

Modified Sgarbossa Criteria - Diagnostic Checklist for diagnosing MI in LBBB or Pacemaker
1) Identify LBBB or

MI in LBBB or Pacemaker ... Identify LBBB or Pacemaker ... axis deviation Pacemaker

Differential Diagnosis for ST Segment Elevations
- ACUTE STEMI
- PULMONARY EMBOLISM
- LBBB

EMBOLISM - LBBB (PACEMAKER

Pacemaker Placement Indications
Class I:
• Third degree block
• Advanced 2nd degree block
• Symptomatic Mobitz

Pacemaker Placement ... BrighamMedRes #Pacemaker

Fibrinous pericardial effusion with tamponade on POCUS

80F w AFib w pacemaker on warfarin presents with n/v

80F w AFib w pacemaker ... hemorrhagic #POCUS #Clinical

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Temporary / External Pacing
• Transvenous & epicardial pacing are temporary methods of supporting brady- &

permanent implanted pacemaker ... MD @nickmmark #pacemaker

Approach to ECGs
Check
- Age, gender, name
- 25mm/s; 10mm/mV
- 1mm = 40ms; 0.1 mV
Rate

ectopic atrial pacemaker ... leads rsr'), V-pacemaker

Summary of Heart Blocks
1st Degree Heart Block:
• Prolonged PR >200ms (5 small squares).
• Narrow

• Treatment: Pacemaker ... • Treatment: Pacemaker

The first three letters refer to chamber paced, chamber sensed, and response to sensed events. The

Cardiology #PPM #Pacemaker

Causes of Tachycardia - Differential Diagnosis Algorithm
Narrow Complex - Regular:
• Sinus tachycardia
• Atrial flutter

aberrancy • Pacemaker-facilitated

Cardiac Stress Testing
Exercise:
• Everyone who can exercise should!
• They must be able to raise

heartblock w/o pacemaker

Transvenous Pacing - Procedure Instructions
Step 1. Place the introducer - ideally in R IJ or L

Transvenous #Pacing #Pacemaker

STAGES of CHF (A, B, C, D), however, describe the severity of structural abnormalities that impair

biventricular pacemaker

Syncope - Differential Diagnosis Algorithm
Neurocardiogenic:
• Vasovagal
• Orthostatic Hypotension
• Autonomic Neuropathy
• Situational (micturition,

Block • Pacemaker

Approach to ECGs - Tachy/Bradyarrhythmias
Tachyarrhythmias - HR > 100
Wide
(1) VT - DANGER
(2)

- ventricular pacemaker

Bradycardia - Differential Diagnosis Framework

BRADI Mnemonic
• BRASH/Hyperkalemia
• Reduced oxygen/Glucose/Temp
• ACS
• Drugs
•

Failure of permanent pacemaker

Bradycardia
1) First Steps: IV, O2, Monitors, ECG, Pads on patient, Crash Cart in room. Is patient

Set pacemaker to

Common pediatric rashes you see in clinic. How to differentiate them? Name that rash.

#pediatrics #peds #rashes

rashes you see in clinic ... #peds #rashes #clinical

Dengue Illness - Clinical Course of the Disease - Febrile, Critical, Recovery phases
• Days of

Dengue Illness - Clinical ... Disease - Febrile, Critical ... • Potential clinical

Nerves - Anatomy, Clinical

Anatomy Labeled #Clinical

Clinical Presentation of Conditions That Mimic Cellulitis and True Cellulitis

- Deep Vein Thrombosis
-

Clinical Presentation ... #Diagnosis #Clinical

complications and clinical

Diagnosis and Clinical

Clinical Examination

Acute Pericarditis - EKG Changes

EKG Progression and Symptoms

#Acute #Pericarditis #Changes #EKG #ECG #Electrocardiogram #Diagnosis #Cardiology #Clinical

Diagnosis #Cardiology #Clinical

Central Retinal Vein Occlusion (CRVO)
Clinical:
• Sudden, painless, monocular loss of vision
• "Blood and

Occlusion (CRVO) Clinical ... CRVO #Diagnosis #Clinical

Causes of upper gastrointestinal bleeding - An Illustrated Differential Diagnosis

#Diagnosis #Differential #UpperGI #Bleeding #Diagram #Causes

** GrepMed

Kumar and Clark's Clinical

#Terminology #Clinical

#COVID19FOAM #clinical

stenosis #timelapse #clinical

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#clinical #cardiology

ARDS #Pulmnology #clinical

Clinical Examination

Clinical Manifestations

#PhysicalExam #clinical

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Liver Failure - Clinical

#Clinical #Diagnosis

Clinical Presentation

Dermatomes and Peripheral Nerves - Segmental Innervation of the Skin and the Peripheral Nerve Supply (Anterior

Text: Hutchison's Clinical

disease #phenomenon #clinical

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Diagnosis of active multiple myeloma is not just CRAB; it's actually "SLiM CRAB" @Majorajay & @Vincentrk

#MultipleMyeloma

Hypercalcemia #Anemia #Clinical

Clinical Examination

Clinical Pharmacologic

Chest pain, good story, but nonspecific ECG? Do a bedside echo: regional WMAs support your case

UltrasoundJelly #Clinical

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The Dyspnea Pyramid - Differential Diagnosis for Shortness of Breath

Original Source (Jeff Wiese MD): https://www.acponline.org/system/files/documents/clinical_information/journals_publications/books/clinical-teaching-scripts-for-inpatient-medicine.pdf

#Diagnosis #Dyspnea

journals_publications/books/clinical-teaching-scripts-for-inpatient-medicine.pdf

A serious case of Flail chest. This is a medical emergency!

Medical Talk @TheMedicalTalk

#Flail #Chest #Breathing #Pattern

Trauma #Video #Clinical

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Here are the morphological hallmarks of Rhabdomyosarcoma.

- Broken arrow sign

- tad-pole rhabdomyoblasts

Pathology #Microscopy #Clinical

in children – clinical

Nail diseases and disorders.
- Spoon Nails (Koilonychia)
- Pitting of Nails
- Beau's Lines
-

Leukonychia #Table #Clinical

Table #Diagnosis #Clinical

Kussmaul's Sign in Constrictive Pericarditis on Physical Exam

- Susan Joseph MD @SusanJosephMD

#Kussmauls #Sign #Pericarditis #physicalexam #clinical

#physicalexam #clinical

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NIH NHLBI ARDS Clinical

Serotonin #Syndrome #Clinical

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Kidney Disease - Clinical

Common ultrasound abnormalities seen on kidney and urinary bladder POCUS

- Dr. Abhilash Koratala MD - NephroPOCUS

ultrasound #renal #clinical

#PhysicalExam #clinical

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Myocarditis
Diagnosis
• Endomyocardial biopsy (gold standard, rarely performed)
• Clinical presentation
• Cardiovascular MRI
Clinical
•

performed) • Clinical ... Cardiovascular MRI Clinical

Clinical Examination

$Hypertrophic Cardiomyopathy ECG and Clinical Features #HOCM #Hypertrophic #Cardiomyopathy #Diagnosis #Management #Cardiology$

Cardiomyopathy ECG and Clinical

Abnormal liver function tests algorithm.
This figure details the initial response to abnormal liver blood tests.

evaluation of the clinical ... /or suspicious clinical ... the remainder, a clinical ... elevation and clinical

#diagnosis #clinical

Beta blocker Conversion Table- Carvedilol, Metoprolol and Bisoprolol Equivalents
Converting between Beta-Blockers: Carvedilol, Metoprolol and Bisoprolol

#Pharmacology #Cardiology

Recommended Text: Clinical

ABC's of POCUS
Forming the platform for my CCS2018 talk, ‘POCUS on ITU’! My infographic on the

#ABCs #ABCDEs #clinical

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It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a

just simply a clinical ... range of possible clinical ... determined based on two clinical ... balance and are clinically ... criticalcare #icu #clinical