Elderly female with CHF complains of abdominal pain, nausea and vomiting, dizziness, and confusion for 5 days. What is the cause?
Author: V. Dimov, M.D.Reviewer: S. Randhawa, M.D.A 96-year-old African American female (AAF) was admitted from a nursing home with complaints of abdominal pain, nausea and vomiting (N/V), dizziness, confusion and double vision for 5 days. She was discharged from the hospital just 4 days ago. Digoxin was started during that previous hospitalization for control of tachycardia in atrial fibrillation. One day prior to discharge, digoxin level was 1.8 mg/mL and digoxin dose was decreased to 125 mcg PO Q 48 hr.Past medical history (PMH)Hypertension, atrial fibrillation, coronary artery disease, stroke, congestive heart failure.M...
Source: Clinical Cases and Images - August 2, 2009 Category: General Medicine Tags: Cardiology Intensive Care Toxicology Source Type: news
A Systematic Approach to Electrocardiogram (ECG, EKG) Interpretation by Using 2 Mnemonics
Author: V. Dimov, M.D. Published in theProceedings of the 3rd Annual Cleveland Clinic Perioperative Medicine Summit, CCJM.This is a 2-step approach remembered by 2 mnemonics:Step 1: Evaluate all elements of the EKG systematically:A RARE PQRST.Step 2: Differential diagnosis. Look for diseases that may have caused the abnormalities noted in step 1:DR III EEE !This systematic approach to reading electrocardiograms (ECGs or EKGs) works every time, just like a machine. By using it, you will not miss any major abnormalities in electrocardiograms (EKGs).What is the meaning of the mnemonics?A RARE PQRST:Age, e.g. a 60-yo patient i...
Source: Clinical Cases and Images - July 23, 2009 Category: General Medicine Tags: Cardiology Source Type: news
Abdominal Pain Due to a Large Abdominal Aortic Aneurysm (AAA) and Diverticulosis
Author: V. Dimov, M.D.Reviewer: A. Aneja, M.D.Click here for thecase description and questions.The CT of the abdomen was significant for:1. Large abdominal aortic aneurysm (AAA).2. Diverticulosis.Abdominal aortic aneurysm (AAA) on the CT of the abdomen (click to enlarge the images).Abdominal aortic aneurysm (AAA) on the CT of the abdomen (click to enlarge the images).Diverticulosis on the CT of the abdomen (click to enlarge the images).Report of the CT of abdomen and pelvis with IV contrast:There is a large infrarenal distal abdominal aortic aneurysm (AAA), estimated to measure approximately 8.0 cm A.P. x 7.4 cm transverse...
Source: Clinical Cases and Images - July 11, 2009 Category: General Medicine Tags: Cardiology Gastroenterology Source Type: news
