ABSTRACT
A 69-year-old woman was admitted after a cardiac arrest. She developed status epilepticus and was later found to have variable morphologies of a "spiked helmet sign" (SHS) on ECGs in the setting of prolonged QT interval, raising the question of whether this sign is a manifestation of QT prolongation.
Subject(s)
Electrocardiography , Long QT Syndrome , Humans , Female , Aged , Long QT Syndrome/diagnosis , Long QT Syndrome/physiopathology , Diagnosis, Differential , Status Epilepticus/etiology , Status Epilepticus/diagnosis , Heart Arrest/etiologyABSTRACT
This case report describes a patient in their 60s with gastroesophageal reflex disease who presented to the emergency department after loss of consciousness during dinner and daily intermittent chest discomfort.
Subject(s)
Arrhythmias, Cardiac , Syncope , Humans , Syncope/diagnosis , Syncope/etiologyABSTRACT
Since the nationally televised cardiac arrest of American National Football League player Damar Hamlin in January 2023, commotio cordis has come to the forefront of public attention. Commotio cordis is defined as sudden cardiac arrest due to direct trauma to the precordium resulting in ventricular fibrillation or ventricular tachycardia. While the precise incidence of commotio cordis is not known due to a lack of standardized, mandated reporting, it is the third most common cause of sudden cardiac death in young athletes, with more than 75% of cases occurring during organized and recreational sporting events. Given that survival is closely tied to how quickly victims receive cardiopulmonary resuscitation and defibrillation, it is crucial to raise awareness of commotio cordis so that athletic trainers, coaches, team physicians, and emergency medical personnel can rapidly diagnose and treat this often-fatal condition. Broader distribution of automated external defibrillators in sporting facilities as well as increased presence of medical personnel during sporting events would also likely lead to higher survival rates.
Subject(s)
Cardiopulmonary Resuscitation , Commotio Cordis , Football , Humans , Commotio Cordis/therapy , Commotio Cordis/diagnosis , Commotio Cordis/etiology , Cardiopulmonary Resuscitation/adverse effects , Cardiopulmonary Resuscitation/methods , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/prevention & control , Arrhythmias, CardiacABSTRACT
A previously healthy person in their 60s with progressive shortness of breath and fatigue for the past 6 months presented to the emergency department with palpitations and shortness of breath. What is your diagnosis?
Subject(s)
Dyspnea , Heart Rate , Humans , Dyspnea/diagnosis , Dyspnea/etiologySubject(s)
Atrioventricular Block/diagnosis , Electrocardiography/methods , Aged, 80 and over , Female , HumansSubject(s)
Coronary Vessels/surgery , Electrocardiography/methods , Graft Occlusion, Vascular/diagnosis , ST Elevation Myocardial Infarction/diagnosis , Stents , Aged , Coronary Angiography/methods , Coronary Vessels/diagnostic imaging , Graft Occlusion, Vascular/surgery , Humans , Reoperation , ST Elevation Myocardial Infarction/surgeryABSTRACT
Spontaneous Coronary Artery Dissection (SCAD) is an important cause of myocardial infarction that typically affects women without traditional cardiovascular risk factors. It is the most common cause of myocardial infarction in pregnant and postpartum women. SCAD is often underdiagnosed due to the lack of clinician familiarity, and patients with pregnancy-associated SCAD often have more severe clinical presentations than those without. We present a case of SCAD in a multiparous woman who presented with acute chest pain in the postpartum period.
Subject(s)
Electrocardiography , Wolff-Parkinson-White Syndrome/diagnosis , Adult , Drug Users , Humans , Male , Substance-Related DisordersSubject(s)
Anti-Arrhythmia Agents/adverse effects , Atrial Flutter/diagnosis , Drug-Related Side Effects and Adverse Reactions/diagnosis , Electrocardiography/methods , Flecainide/adverse effects , Tachycardia, Ventricular/drug therapy , Aged , Anti-Arrhythmia Agents/therapeutic use , Atrial Flutter/etiology , Flecainide/therapeutic use , Humans , Male , Tachycardia, Ventricular/diagnosis , Withholding TreatmentABSTRACT
Wolff-Parkinson-White pattern is a relatively common electrocardiographic phenomenon caused by accessory atrioventricular (AV) conduction, which can make the diagnosis of acute myocardial infarction challenging. There is little existing literature regarding the interpretation of electrocardiograms in patients with accessory AV conduction pathways who present with acute myocardial infarction. We describe a case of electrocardiographic evolution of acute ST-segment elevation myocardial infarction in a patient with Wolff-Parkinson-White pattern, review pseudo-infarction patterns, and discuss proposed mechanisms for these repolarization abnormalities.
