You are managing a 72 year old female who has presented to the emergency department with sudden onset of dizziness and difficulty breathing. The patient’s pulse rate is recorded as 44 beats per minute. Your assessment focuses on identifying reversible causes of bradycardia. Which of the following metabolic conditions is commonly associated with reversible bradycardia?
A 42-year-old woman presents with central chest pain that has been intermittent for the past few weeks. She reports that it tends to occur when she is climbing stairs or walking uphill but subsides quickly when she rests. Her medical history includes type 2 diabetes mellitus, which is managed with metformin, and gastroesophageal reflux disease (GERD), for which she takes lansoprazole. On examination, her heart sounds are normal, and her chest is clear.
What is the SINGLE most probable diagnosis?
A 65 year old male is brought to the emergency department following a fall which occurred while the patient was getting out of bed. The patient complains of feeling dizzy as he got out of bed before experiencing tunnel vision and briefly losing consciousness. The patient is certain he only blacked out for a few seconds as the time on the bedside clock had not changed. The patient informs you that he has had several similar episodes over the past few months when getting out of bed, but most of the time he only feels dizzy and doesn’t faint. He denies any loss of bladder or bowel control or biting his tongue. An ECG is performed which shows normal sinus rhythm. You note the patient takes the following medication:
Lisinopril 10 mg OD
Fluoxetine 20 mg OD
What is the most likely diagnosis?
A 72 year old male is brought to the emergency department by ambulance after experiencing severe chest pain while walking his dog. The patient complains of feeling nauseated and states that the pain spreads to his neck. An ECG is conducted, revealing ST elevation in leads I and AVL. Which coronary artery is most likely blocked?
You are asked to assess a 68-year-old male in the resuscitation room due to bradycardia. The patient complained of increased shortness of breath, dizziness, and chest discomfort. The recorded vital signs are as follows:
Parameter Result
Blood pressure 80/52 mmHg
Pulse rate 40 bpm
Respiration rate 18 rpm
SpO2 98% on 12 liters Oxygen
You are concerned about the possibility of this patient progressing to asystole. Which of the following indicators would suggest that this patient is at a high risk of developing asystole?
A 60-year-old woman presents with complaints of fatigue and difficulty breathing. During the examination, you observe a pansystolic murmur that is most prominent at the apex and radiates to the axilla. The murmur is more pronounced during expiration.
What is the SINGLE most probable diagnosis?
A 42 year old male comes to the emergency department with a sudden onset of ‘tearing’ pain in the middle of his chest that extends to the center of his back. The patient is tall and has a slender physique. Additionally, you observe that the patient has elongated arms and fingers. During the chest examination, you notice a prominent protrusion of the sternum (pectus carinatum). What is the probable underlying cause of this patient’s chest pain?
A 68 year old man is brought to the emergency department due to sudden difficulty breathing. During auscultation, you detect a murmur. The patient then undergoes a bedside echocardiogram which reveals mitral regurgitation. What murmur is commonly associated with mitral regurgitation?
A 68 year old man is brought to the emergency department due to sudden difficulty breathing. Bedside echocardiography reveals significant mitral regurgitation. What is a common clinical characteristic of mitral regurgitation?
A 72 year old male patient presents to the emergency department complaining of worsening shortness of breath. You observe moderate mitral stenosis on the patient’s most recent echocardiogram 10 months ago.
What is a typical finding in individuals with mitral stenosis?