>90 yo to ED with hypoxia and tachycardia ddimer >13.5 tropo | Figure 1

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90 yo to ED with hypoxia and tachycardia ddimer >13.5 troponin elevated. Ultimately Dx With saddle embolus.

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42yo male c/o chest pain and severe dyspnea made worse with exertion. Low 80's on room air other VS relatively normal aside from being a little tachy at times. No productive cough, chills or fever. Hx HTN and episodes of AFib in the past. Trop negative and DDimer 18.2. CT shows, "extensive emboli extending into segmental branches of all lobes."

Dispatched to a clinic for a 22 y/o f with difficulty breathing, handed this 12 lead on arrival.

79 y/o male c/o dyspnea and weakness x 2 days. Recently returned from Europe (Germany, Switzerland) Hx of HTN and high cholesterol. Rx HCTZ and Amlodepine. Denies other cardiac hx, no hx of A Fib or Rx antidysrhythmics. BP 180/110, HR 90 to 130, irregular. RR 19, RA SpO2 90%, lungs CBL. Pt. placed on 4 lpm O2 via nasal cannula, 18 g SL, blood draw performed, BG 140mg/dl. SpO2 increased to 99%. BP on arrival was 140/80.

70s M presented to ED w CP and elevated d-dimer. Sent home until the scan was re-reviewed by the radiologist and he received a bit of an urgent phone call. Remember: PE isn't the only badness that can cause CP and elevated d-dimer...

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Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this EKD that would warrant further work-up or is this just a pediatric EKG?