This 96 year old man was taken to the Emergency Department (ED) after an unwitnessed fall at his Nursing Home. He sustained a lacerated scalp. He is not on any anticoagulant drugs. He suffers from moderate dementia, and has recurrent falls.
This post is based on a talk given to Emergency Department Registrars in August 2016. The theme is "Looking at an Electrocardiograph"
I would like to approach this topic through the works of Paul Klee. Paul Klee (1879-1940) was born to a German father and a Swiss mother...
These tracings are from a elderly man who presented with a acute myocardial infarct (AMI) in 1982. This was when I began to collecting interesting or puzzling or intriguing ECGs. This was also the era of "roll your own ECG"
The patient is a 24 year old Sri Lankan man with a 4 day history of increasing dyspnoea, with exercise tolerance limited to 200 metres. He has not had a cough or chest pain or fever. Four weeks ago he had a self-limited influenzal type illness.
This is the first of three cases with a theme of T wave changes...
Vladimir is a 77 year old man with a history of hypertension and mitral valve replacement that requires anticoagulation with warfarin.
This 21 year old man was found lying on the ground next to a bus stop at 0620 hours on a Sunday morning where the minimum overnight temperature was 60 C. An ambulance was called, and their findings on arrival were
The body is a complex and marvellous thing. In the words of Nathanael West (1903-1940): "Under the skin of man is a wondrous jungle where veins like lush tropical growths hang along over-ripe organs and weed-like entrails writhe in squirming tangles of red and yellow".
This is the rhythm strip of a 72 year old woman taken shortly after she arrived in the Emergency Department after an episode of syncope. The ambulance officers recorded an episode of non sustained ventricular tachycardia just before the patient arrived.
What are we seeking when we look at an ECG? We may be looking for normality, or for findings that confirm or support our clinical suspicion. Often we find changes that are “non-specific” or else are clear-cut but are unrelated to the current problem. Perhaps we should call the latter changes “distractors”. This case highlights some of these issues.