Clinical Documentation
Introduction Good documentation is easy to follow, provides a logical explanation of the conclusions made, the response to interventions and makes clear the way forward Bad documentation results in misled… Read more »
Shock – Bedside Ultrasound Guided Management
Introduction Cardiac Ultrasound is a non-invasive adjunct in the evaluation and management of shock by those involved in critical care Ultrasound has value in evaluating volume status and cardiac function It… Read more »
Myocardial Ischaemia – ECG lead correlation
INTRODUCTION For ST/T wave changes to be consistent with myocardial ischaemia, they have to be in contiguous leads adjacent to a localised segment of the heart Find the correlation between… Read more »
Source of Infection
Introduction Usually a thorough review of systems on history is enough to identify the likely source of infection (the screening questions on the left side column is generally adequate)… Read more »
ACS/STEMI mimics
ACS/STEMI mimics seen in acute pathology Other acute cardiac pathology Acute Non-cardiac pathology ACS/STEMI mimics Conduction abnormalities Pre-existing structural cardiac disease Normal variants
ACS/STEMI mimics – Acute Cardiac Pathology
Pericarditis Saddle shaped ST elevation in multiple leads PR depression Spodick’s sign in right-ward leads Pleuritic pain relieved sitting forward Takotsubo cardiomyopathy See STEMI Echo – apical hypokinesis Recent emotionally… Read more »
ACS/STEMI mimics – Normal variants
Benign Early Repolarisation Mild ST elevation and T waves in precordial leads Notching J point (fish-hook) Less prominent in tachycardia Young, healthy adults
ACS/STEMI mimics – Structural heart disease
Ventricular aneurysm ST elevation in antero-septal leads Old Q waves Check old ECG and history of MI Left ventricular hypertrophy Up-sloping ST elevation in antero-septal leads Down-sloping ST in lateral… Read more »
ACS/STEMI mimics – Conduction Abnormalities
Conduction abnormalities Brugada syndrome ST coved elevation septal leads Partial RBBB morphology History of sudden cardiac death in family especially in Asia Bundle Branch Block (left or right) ST/T changes… Read more »
ACS/STEMI mimics – Acute Non-cardiac Pathology
Acute Non-cardiac pathology Pulmonary embolism ST elevation lead III Sinus Tachycardia or AF RBBB Right heart strain pattern S1Q3T3 Review major risks for PE Raised ICP (any cause) Can be… Read more »