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Electrocardiographic Findings in a Young Man With Tachycardia and Hypotension

Electrocardiographic Findings in a Young Man With Tachycardia and Hypotension A 25-year-old man presented to the emergency department complaining of shortness of breath, cough, and malaise, which had progressed over the preceding several weeks. He had a 7-year history of daily methamphetamine use. He had presented to the emergency department 3 times in the previous month complaining of similar symptoms and had been discharged with treatment for an upper respiratory infection; there was no evidence of hemodynamic instability. At this presentation, however, his blood pressure was 95/60 mm Hg, his heart rate was 114 beats/min, and his oxygen saturation was 98% on room air. Physical examination revealed a jugular venous pressure of 15 cm H2O, bilateral pulmonary rales, an inferolaterally displaced point of maximal impulse, and an S3 gallop, all of which were new findings compared with those of previous examinations. A chest x-ray film revealed bibasilar pulmonary infiltrates, consistent with pulmonary edema, and an enlarged cardiac silhouette. An electrocardiogram (ECG) was obtained (Figure 1). View LargeDownload Figure 1. Questions: What are the critical findings on this ECG and what is the cause? Answer http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Electrocardiographic Findings in a Young Man With Tachycardia and Hypotension

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Electrocardiographic Findings in a Young Man With Tachycardia and Hypotension

Abstract

A 25-year-old man presented to the emergency department complaining of shortness of breath, cough, and malaise, which had progressed over the preceding several weeks. He had a 7-year history of daily methamphetamine use. He had presented to the emergency department 3 times in the previous month complaining of similar symptoms and had been discharged with treatment for an upper respiratory infection; there was no evidence of hemodynamic instability. At this presentation, however, his blood...
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Publisher
American Medical Association
Copyright
Copyright © 2012 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinternmed.2012.2727
Publisher site
See Article on Publisher Site

Abstract

A 25-year-old man presented to the emergency department complaining of shortness of breath, cough, and malaise, which had progressed over the preceding several weeks. He had a 7-year history of daily methamphetamine use. He had presented to the emergency department 3 times in the previous month complaining of similar symptoms and had been discharged with treatment for an upper respiratory infection; there was no evidence of hemodynamic instability. At this presentation, however, his blood pressure was 95/60 mm Hg, his heart rate was 114 beats/min, and his oxygen saturation was 98% on room air. Physical examination revealed a jugular venous pressure of 15 cm H2O, bilateral pulmonary rales, an inferolaterally displaced point of maximal impulse, and an S3 gallop, all of which were new findings compared with those of previous examinations. A chest x-ray film revealed bibasilar pulmonary infiltrates, consistent with pulmonary edema, and an enlarged cardiac silhouette. An electrocardiogram (ECG) was obtained (Figure 1). View LargeDownload Figure 1. Questions: What are the critical findings on this ECG and what is the cause? Answer

Journal

Archives of Internal Medicine – American Medical Association

Published: Aug 13, 2012

Keywords: electrocardiogram,tachycardia,hypotension

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