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Post by kemple on Jun 24, 2015 20:26:50 GMT -5
As above with intermittent loss of vision like curtain over R eye. EKG below...thoughts. ![]()  |
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Post by pbruss on Jun 25, 2015 6:19:35 GMT -5
low votlage, suspicious electrical alternans, relative right atrial enlargment with p waves in 2,3,avf. pericarditis? pericardial effusion? valvular problem? PFO? aortic dissection? diagnosed autoimmune disorder causing hypercoagulable state (lupus, sle, ect)?
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Post by tyson on Jun 25, 2015 8:40:08 GMT -5
prolonged qt vs hypokalemia. both could cause pre-syncopal or syncopal events.
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Post by kemple on Jun 25, 2015 13:41:33 GMT -5
Well you both fell for it, check the amplitude test just before leads I, II, and III. The EKG wasn't calibrated correctly by the tech.
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Post by tyson on Jun 25, 2015 16:28:14 GMT -5
dammit! then what's causing the intermittent loss of vision?
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Post by kemple on Jul 7, 2015 7:41:57 GMT -5
Neuro admitted as TIA, wasn't my pt so I'm not 100% sure.
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Post by pbruss on Jul 8, 2015 6:02:22 GMT -5
well get 100% sure.
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Post by jpollock on Jul 10, 2015 10:38:46 GMT -5
One of the other Docs had a case last week where the patient was having intermittent vision loss described as "a curtain coming down over both eyes". We were stumped. Retinal detachment usually only is in one eye and doesn't come and go like that. Possible vertebral dissection / TIA?
Well, the patient went into a run of Vtach in the ER and when the ER doc went in the room the patient was having the same curtain coming down. Learning point: when the patient has "vision changes" make sure they aren't describing pre-syncope
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Post by kemple on Jul 11, 2015 13:02:31 GMT -5
good call
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