Figure 1

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Walked in to the clinic with complaint of a cough and palpitation. Hx: DM, AFIB WITH RVR, old drug abuse. #SVT


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STUDENTS let's play.... Patient One: What is this rhythm? What clinical findings and procedures did we do in the field prior to hospital? How do you think the patient(s) presented? What medication(s) did we give? Dosage(s)? Patient Two: when said medication(s) from earlier this week didn't work on patient two what is the next step we can perform in the field to return the heart to a much more appropriate rate/rhythm? What other unique things can we try for these patients? If you haven't learned anything by the end of this post alway manually feel a pulse. What a shocking week I had. Eh?

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

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70 yo WF with 20y hx HTN lost 21 lbs on a semaglutide but still BMI over 30, shows drop in BP when standing, stabilizing at 102-116 systolic, 65-75 diastolic. Discontinued all HTN meds x 30 days and no episodes of HTN. Could a small weight loss like this cause a drop to normal BP? Has anyone heard of a side effect of lowering BP?