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ECG OF THE WEEK

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Each Week we put up one ECG case for you....because it's easier to learn from cases.
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A 68 YO WOMAN WITH WORSENING SOB

15/6/2021

1 Comment

 
This year at the Cardiac Bootcamp face to face course in Sydney we had a fantastic turnout and we went over a huge amount of content in Acute Cardiology and reading ECGs.
There were some ECGs that we looked at, as part of the ECG Quiz.
​Here is one of those ECGs, to test your memory and to reinforce some of the most important things we learnt about this case.
A 68 yo woman presented with worsening SOB over the previous 24 Hours. She now also had chest pain and was speaking in very short phrases.
​She was a smoker, with a past medical history of COPD and hypertension.
Her vitals were:
  • HR 115
  • BP 87/42
  • RR 31
  • Sats 94% on room air
  • Temp 36.2
Her examination showed dual heart sounds, with some crepitations in the right base and her abdo was soft.
Her blood pressure dropped to 65/32 before peripheral inotropes were commenced.
Her ECG and Chest Xray are shown below. What is your diagnosis?
Picture
Picture
There is a pericardia effusion diagnosed on LOW VOLTAGE CRITERIA.
Small complexes and tachycardia = pericardial effusion.
The are Sensitive Criteria and Specific criteria for picking low voltage on an ECG.
This was all part of the 'SHOCKED' A mnemonic on Cardiac Bootcamp Course, to minimise missed cases.
Picture
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1 Comment
Busty Escorts Duluth link
9/3/2025 06:55:38 pm

I find it fascinating how low voltage criteria can help diagnose pericardial effusion.

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    Author

    Dr Peter Kas
    ​Emergency Physician

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