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cardiology diagnosis differential management ecg ekg electrocardiogram lbbb potassium causes clinical comatose criteria high ischemia modified nephrology sgarbossa stelevation activation
Approach to ECGs - Ischemia MI = Biomarkers + ECG or echo/angiogram findings Pathologic Q - 1/3 height
new/old infarct STEMI ... big R or R/S>I STEMI ... have no pain - LAD ... avR - proximal LAD ... electrocardiogram #cardiology #STEMI
Hyperkalemia Differential Diagnosis Algorithm R/O Pseudo-hyperkalemia: • Possible Lab error! Alwavs Repeat Blood sample! • Leukocytosis, Thrombocytosis:
Hyperkalemia Differential ... Diagnosis Algorithm ... R/O Pseudo-hyperkalemia ... : • Possible Lab ... Differential #Diagnosis #Algorithm
Hyperkalemia: Diagnostic algorithm Decreased renal potassium excretion • Acute renal failure • Chronic renal failure • Drugs Increased
Hyperkalemia: Diagnostic ... algorithm Decreased ... Increased potassium load ... • Type 1 #Hyperkalemia ... #Diagnosis #algorithm
Modified Sgarbossa Criteria - Diagnostic Checklist for diagnosing MI in LBBB or Pacemaker 1) Identify LBBB or
Criteria - Suspect STEMI ... a) Concordant STE ... > 1 mm in any lead ... V1-V3 c) STE ... wave > 25% in any lead
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM INCLUSION CRITERIA Acute Myocardial Infarction  Ischemic Symptoms  EKG and/or biomarker evidence of AMI
SHOCK INITIATIVE ALGORITHM ... evidence of AMI (STEMI ... or NSTEMI) Cardiogenic ... ACTIVATE CATH LAB ... Cardiogenic #Shock #Algorithm
Causes of ST Segment Elevation - Differential Diagnosis Framework STEMI: • Upsloping convex STE: "Pardee's sign" +
Diagnosis Framework STEMI ... ventricle pacing lead ... Disorders: • Hyperkalemia ... no P waves • Hypercalcemia ... STElevation #ST #STEMI
Hyperkalemia EKG - K of 8.5 Here’s an #ECG of a man with ROSC after cardiac arrest Computer
Hyperkalemia EKG ... Computer is calling STEMI ... classic “Pseudo-STEMI ... is a contrast load ... @EM_RESUS #Hyperkalemia
Causes of Altered Level of Consciousness GCS < 7 - Differential Diagnosis Algorithm Brain Involvement - Hemispheric
Differential Diagnosis Algorithm ... Involvement - Brain Stem ... Herniation • Brain stem ... Hypernatremia • Hypercalcemia ... Differential #Diagnosis #Algorithm
LAD IWMI LAHB RAD [PHB RVH Lateral wall infarct Lead reversal Dextrocardia Wide ORS RBBB - terminal delay [BBB IVED WPW = delta wave Hyperkalemia Type l antiarrhythmic drugs Pacemaker ST elevation Early repolarization
LAD IWMI LAHB ... = delta wave Hyperkalemia ... Elevation AcutE STEMI ... Nonconducted APC #LAD ... LBBB #IVED #WPW #Hyperkalemia
Recurrent Polymorphic VT/Torsades de Pointes - Management Algorithm Drugs that prolong QT interval: • Class 1a (quinidine,
Pointes - Management Algorithm ... Hypomagnesemia • Hypokalemia ... infusion after load ... evidence • Load ... TDP #Management #Algorithm
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