Grand Rounds Recap March 30, 2016

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Grand Rounds Recap March 30, 2016

M&M with Dr. LaFollette

Modified Sgarbossa Criteria to aid in diagnosing STEMI in the setting of LBBB

  • Can be used in the setting of induced (paced) LBBB
  • Unweighted scoring (any of the following indicates STEMI equivilance)
    • Concordant ST elevation
    • Concordant ST depression in V1,V2,V3
    • Inappropriate discordance of >25% ST elevation / S wave amplitudes
  • Improves your test metrics from the original criteria from sens/spec of 36%/96% to 80%/99% respectively in a new validation study

 

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Annals of B-Pod: #lessonslearned

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Annals of B-Pod: #lessonslearned

Beware! Aortic Dissection

#lessonslearned is a case series submitted by former senior residents describing B-pod cases that taught them the art of medicine

Case 1

A male in his 30s with a past medical history significant for hypertension presented via EMS with pain all over, anxiety and shortness of breath. The EMTs reported that he had smoked marijuana about 30 minutes before his presentation from his normal supply. At the scene he was noted to be very agitated, diaphoretic and vocal about his pain. He was yelling that he was hurting all over, he was having trouble breathing, and that he wanted to be sedated. He states that he has never had problems like this.

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