ECGs for the Emergency Physician 1

Amal Mattu, William J. Brady, William J. Brady

• Publisher: BMJ Books
• Year: 2013
• ISBN:
  9781118682159
• Edition: 1
• Topic: Medizin
• Subtopic: Notfallmedizin & Intensivmedizin

With over 200 traces to test your knowledge, this book is a first class learning tool for emergency physicians. Basic student-level knowledge of ECGs is assumed, so the reader can move directly to learning about the more complex traces that occur in the emergency department. The level of difficulty is stratified into two sections for specialists in training and specialist emergency physicians.

A minimum amount of information is given beneath each trace, as if in the real situation. The full clinical description is printed in a separate section to avoid the temptation of "looking".

Accompanied by learning points, and with the cases presented randomly, this book provides a rich source of information on the interpretation of ECGs – a core skill for all emergency department staff.

Part 1

Case histories

1. 45 year old woman, asymptomatic

2. 24 year man with chest ache after lifting weights

3. 76 year old man with dyspnea

4. 64 year old man, asymptomatic

5. 48 year old woman reports severe lightheadedness with walking; she recently started a new medication for hypertension

6. 79 year old man 45 minutes after receiving thrombolytic therapy for acute myocardial infarction; currently pain-free

7. 43 year old man, asymptomatic

8. 82 year old man recently increased his dose of a beta-receptor blocking medication; he now reports exertional lightheadedness

9. 49 year old man with occasional episodes of chest pain

10. 65 year old woman with a long history of smoking presents for treatment of an emphysema exacerbation

11. 54 year old woman complains of midsternal chest pain and lightheadedness

12. 86 year old woman complains of generalized weakness

13. 61 year old man with palpitations and lightheadedness

14. 44 year old woman with intermittent episodes of palpitations

15. 24 year old pregnant woman with three days of frequent vomiting

16. 37 year old man with pleuritic chest pain

17. 63 year old man with palpitations and lightheadedness

18. 33 year old obese man with sharp chest pain and dyspnea

19. 81 year old woman with palpitations and generalized weakness

20. 61 year old man, asymptomatic

21. 57 year old woman with mild chest pain and palpitations

22. 75 year old man presents with cough, dyspnea, and wheezing

23. 43 year old man with severe palpitations

24. 52 year old homeless, alcoholic man found lying in an alley

25. 68 year old man with history of congestive heart failure complains of dyspnea

26. 85 year old woman reports a recent syncopal episode

27. 40 year old woman with palpitations and lightheadedness

28. 35 year old woman with dyspnea

29. 41 year old woman with chest pain after cocaine use

30. 57 year old man with chest pressure and diaphoresis

31. 57 year old man with chest pressure and diaphoresis (right-sided precordial leads)

32. 60 year old woman with acute onset of expressive aphasia

33. 54 year old man 24 hours after receiving thrombolytic therapy for acute myocardial infarction; currently asymptomatic

34. 41 year old woman with nausea and vomiting

35. 75 year old woman accidentally took too many of her beta-blocker tablets

36. 68 year old man with palpitations and generalized weakness

37. 38 year old man with chest pain, nausea, and diaphoresis

38. 62 year old woman with palpitations

39. 74 year old man with chest pain and palpitations

40. 45 year old man with severe left chest pressure, nausea, and dyspnea

41. 45 year old man with left chest pressure

42. 85 year old woman presents after a syncopal episode, still reports lightheadedness

43. 81 year old man being admitted for pneumonia

44. 71 year old woman with chronic renal insufficiency presents with carpopedal spasm

45. 46 year old man with chest and left arm pain, vomiting, and diaphoresis

46. 53 year old diabetic woman with four days of nausea, vomiting, and lightheadedness

47. 85 year old woman with chest pain

48. 66 year old man with severe lightheadedness and diaphoresis

49. 58 year old man with congestive heart failure reports increasing dyspnea and lower extremity edema

50. 43 year old man reports eight hours of left chest and arm pain

51. 52 year old woman with chest pain

52. 62 year old man with renal failure complains of progressive dyspnea and orthopnea after missing his last two hemodialysis sessions

53. 47 year old man with palpitations and dyspnea

54. 48 year old woman presents after a clonidine overdose

55. 23 year old man reports dyspnea and palpitations

56. 57 year old man reports generalized weakness and palpitations

57. 54 year old man with five days of anorexia, nausea, and vomiting

58. 66 year old woman with epigastric pain, nausea, dyspnea, and diaphoresis

59. 70 year old woman with nine hours of chest pain and dyspnea

60. 52 year old alcoholic woman presents with frequent vomiting

61. 45 year old woman with palpitations and lightheadedness

62. 45 year old man with severe lightheadedness

63. 52 year old man with sharp chest pain

64. 71 year old woman with generalized weakness

65. 34 year old woman presents unconscious with respiratory depression and pinpoint pupils

66. 36 year old woman has had intermittent episodes of palpitations and lightheadedness

67. 70 year old woman with chest discomfort and generalized weakness

68. 41 year old man with end-stage renal failure presents with generalized weakness after missing his last three hemodialysis sessions

69. 45 year old woman with left chest and arm pain and dyspnea

70. 78 year old woman with dyspnea and nausea

71. 75 year old woman presents after a syncopal episode

72. 50 year old woman with chest pain and diaphoresis for five hours

73. 59 year old man presents with dyspnea, cough, and hypoxia

74. 62 year old woman with chest pain and severe dyspnea gradually worsening for three days

75. 40 year old man with sharp left-sided chest pain and dyspnea

76. 28 year old woman with palpitations and chest pain

77. 53 year old man with left arm “squeezing sensation” and nausea for eight hours

78. 69 year old woman with severe nausea and dyspnea

79. 68 year old man presents unconscious with blood pressure 108/60

80. 65 year old woman with “funny feeling in chest”

81. 55 year old woman with occasional syncopal episodes and a recent episode of palpitations

82. 69 year old man with dyspnea and diaphoresis

83. 79 year old man with abdominal pain

84. 85 year old man with palpitations and fatigue

85. 63 year old man with epigastric burning, belching, diaphoresis, and lightheadedness

86. 70 year old man with dyspnea and generalized weakness

87. 70 year old woman with nausea, vomiting, and diaphoresis

88. 55 year old morbidly obese woman with generalized abdominal pain

89. 44 year old chronic alcoholic with persistent vomiting; becomes unresponsive during the ECG

90. 25 year old woman with palpitations and lightheadedness

91. 28 year old woman eight weeks pregnant presents with chest pain, dyspnea, and blood pressure 80/40

92. 47 year old woman with chest pain; now pain free after use of sublingual nitroglycerin

93. 38 year old woman with chest pain, dyspnea, fever, and productive cough

94. 46 year old woman with episodic palpitations, frequent diaphoresis, and a 15 pound weight loss over the past one month

95. 84 year old woman with nausea and vomiting

96. 57 year old man with chest pressure, dyspnea, and nausea

97. 57 year old man with chest pressure...