Slide 1: What’s the dx? [EKG] 25M fell off his bike. Now with chest pain. HR 130. BP 90/60.
Slide 2: Throwback: low voltage! [EKG showing avg amplitude < 5mm in the limb leads AND avg amplitude < 10mm in the precordial leads] New: electrical alternans!
Slide 3: Among patients with pericardial effusion, the sensitivity/specificity for tamponade: Low voltage – sensitivity 56%, specificity 74%; electrical alternans – sensitivity 23%, specificity 98%; tachycardia – sensitivity 76%, specificity 60%. Next step?
Slide 4: Ultrasound! [Tamponade gif]
- Eisenberg MJ, de Romeral LM, Heidenreich PA, Schiller NB, Evans GT Jr. The diagnosis of pericardial effusion and cardiac tamponade by 12-lead ECG. A technology assessment. Chest. 1996 Aug;110(2):318-24. PMID 8697827
Tags: cardiology, Chest pain, electrical alternans, low voltage, pericardial effusion, sensitivity, specificity, tamponade, ultrasound