{"id":656,"date":"2016-08-14T00:01:48","date_gmt":"2016-08-14T00:01:48","guid":{"rendered":"http:\/\/torreyekg.com\/?p=656"},"modified":"2016-08-04T14:47:30","modified_gmt":"2016-08-04T14:47:30","slug":"ekg-of-the-week-40","status":"publish","type":"post","link":"http:\/\/torreyekg.com\/index.php\/2016\/08\/14\/ekg-of-the-week-40\/","title":{"rendered":"EKG of the Week #40"},"content":{"rendered":"<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/08\/40.png\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/08\/40.png\" alt=\"40\" width=\"647\" height=\"343\" class=\"alignnone size-full wp-image-662\" srcset=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/08\/40.png 647w, http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/08\/40-300x159.png 300w\" sizes=\"auto, (max-width: 647px) 100vw, 647px\" \/><\/a><br \/>\n74-year-old man presents with dyspnea on exertion and increasing peripheral edema<\/p>\n<div class=\"spoiler-wrap\"><div class=\"spoiler-head collapsed\" title=\"Expand\">Answer &amp; Explanation<\/div><div class=\"spoiler-body\" style=\"display: none;\"><br \/>\nThis EKG is striking in several ways\u2026<br \/>\n\tAtrial fibrillation with slow ventricular response at 54\/min<br \/>\n\tRight axis deviation<br \/>\n\tExtreme low voltage in the limb leads\n<p>Exam revealed\u2026<br \/>\n\tVS:  138\/68  66  24  O2sat 90%  982<br \/>\n\tClear lungs, distant heart sounds, +JVD, 2+ pretibial edema<\/p>\n<p>CXR<br \/>\n<a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/08\/401.png\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/08\/401.png\" alt=\"401\" width=\"207\" height=\"174\" class=\"alignnone size-full wp-image-663\" \/><\/a><\/p>\n<p>Hopefully you were concerned with the possibility of a large pericardial effusion, or even tamponade, with the low voltage on the EKG, some aspects of the physical exam, and then the \u201cwaterbottle\u201d cardiomegaly on CXR!  The next step in managing this patient was bedside ultrasound (not pericardiocentesis as hemodynamically stable).<\/p>\n<p>Bedside ultrasound revealed no pericardial fluid but a massively dilated right ventricle?!<br \/>\n<\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>74-year-old man presents with dyspnea on exertion and increasing peripheral edema<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-656","post","type-post","status-publish","format-standard","hentry","category-ekg-of-the-week"],"_links":{"self":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/656","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/comments?post=656"}],"version-history":[{"count":4,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/656\/revisions"}],"predecessor-version":[{"id":666,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/656\/revisions\/666"}],"wp:attachment":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=656"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=656"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=656"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}