This drug was administered and this strip was recorded

#case181 ❤️

65 y female KCO:COPD with 10 days chest pain

The correct answer is “Junctional rhythm, Isorrhythmic AV dissociation and inferoposterior MI”

Narrow complexes at a rate of ~70 which are not preceded by P waves suggest (accelerated) #junctional_rhythm.

There are p waves right after QRS complexes with a rate fairly (not exactly) similar to the rate of QRS complexes that indicates #Isorhythmic_AV_dissociation.

There are STT changes compatible with #inferoposterior wall MI.
Inferior MI is suggested by presence of these changes in the inferior leads:
• ST-elevation
• Q wave

Posterior MI is suggested by the following changes in V1-3:
• Horizontal ST depression
• Tall, broad R waves
• Dominant R wave (R/S ratio>1)

Thanks to my friend Salvatore Pezzella for such a beautiful scheme

#case182 ❤️

70 y male KCO:DM, HTM and CKD presented with nausea, vomiting and confusion. the patient was hypotensive with O2 saturation of 77%

The correct answer is “Hyperkalemia”

Effects of hyperkalemia on the ECG:

K > 5.5 mEq/L
Peaked T waves (usually the earliest sign of hyperkalaemia)

K > 6.5 mEq/L
P wave widens and flattens
PR segment lengthens
P waves eventually disappear

K > 7.0 mEq/L
Wide QRS complexes with bizarre QRS morphology
ST elevation
High-grade AV block
Any kind of conduction block (bundle branch blocks, fascicular blocks)
Sinus bradycardia or slow AF
Development of a sine wave appearance

K > 9.0 mEq/L
Asystole
Ventricular fibrillation
PEA with bizarre, wide complex rhythm