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Sam Ghali, M.D.
ER Doctor | Resuscitation | Airway | Emergency Ultrasound | Cardiovascular Emergencies | ECGs | Trauma | Critical Care | | Patient Advocate
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Sam Ghali, M.D. retweeted
Sam Ghali, M.D. 19h
Replying to @EM_RESUS
Answer: Apical Hypertrophic Cardiomyopathy Here's a bedside shot of the LV Apex on Echo showing profound hypertrophy(>3cm!) Remember the pattern above showing high voltage + classic distribution of deep T wave inversions, & consider this diagnosis when you see it!
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Sam Ghali, M.D. 10h
Replying to @ArgaizR
RBBB + LPFB
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Sam Ghali, M.D. 16h
Good question. They are just different patterns. The best way to answer this is to just look at ECG examples of HOCM vs Apical HOCM. The striking hallmark of the latter is deep T wave inversion across the precordium.
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Sam Ghali, M.D. 19h
Replying to @doctorocky
Yes!
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Sam Ghali, M.D. 19h
Replying to @EM_RESUS
Answer: Apical Hypertrophic Cardiomyopathy Here's a bedside shot of the LV Apex on Echo showing profound hypertrophy(>3cm!) Remember the pattern above showing high voltage + classic distribution of deep T wave inversions, & consider this diagnosis when you see it!
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Sam Ghali, M.D. 23h
Replying to @snbotulism
Thank you Jackie!
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Sam Ghali, M.D. Jul 15
Yes. Although you do frequently also see RBBB + LAFB with S waves retained in the lateral leads. This seems to be related to the degree of the RBBB. Usually see this when the RBBB is really wide.
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Sam Ghali, M.D. Jul 15
Sinus Rhythm. Long PR + RBBB + LAFB (Trifasicular Block). You wouldn’t know if the long PR is from delay at the AV Node or LPF without EP study looking at AH/HV intervals. Either way there is profound conduction disease.
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Sam Ghali, M.D. Jul 15
Replying to @ndspinelli
Thanks Nick!
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Sam Ghali, M.D. Jul 15
Here’s the of a 30-year-old young man who presented to the ER with chest pain. No known medical problems. No meds. No drug use. He was stable and in no acute distress. What’s the diagnosis?
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Sam Ghali, M.D. Jul 14
Replying to @choo_ek
Get the kitten!
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Sam Ghali, M.D. Jul 14
🤜
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Sam Ghali, M.D. Jul 14
Replying to @emloudy_
♥️
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Sam Ghali, M.D. Jul 14
Great thread Mark! 👌 And so important.
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Sam Ghali, M.D. Jul 14
Replying to @SadCat002
You’re sweet! Thank you Jacqueline. 🙏
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Sam Ghali, M.D. Jul 14
doctors who start yelling and screaming for no fucking reason during a resuscitation should be escorted out by security
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Sam Ghali, M.D. Jul 14
Replying to @EM_RESUS
Please remember the important concepts in this thread and share them with others and I promise you will save lives. [End]
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Sam Ghali, M.D. Jul 14
Replying to @Delta
I’m not sure whether it’s true or not that doesn’t carry narcan, but if they don’t, they definitely should (all commercial airlines should). Regardless, this man didn’t have to die. [9/x]
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Sam Ghali, M.D. Jul 14
Replying to @EM_RESUS
As long as you are breathing for them, you will keep them alive. Have someone confirm they have a pulse and just keep giving breaths at a normal breathing rate until either they wake up or more help arrives. [8/x]
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Sam Ghali, M.D. Jul 14
Replying to @EM_RESUS
Ideally these BVM devices should be hooked up to oxygen, but even if they aren’t, they will still deliver breaths using plain room air. [7/x]
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