Thread by @COREIMpodcast

1/ Goood morning, #medtwitter! It’s #12LeadThursday, and you know what that means!

Remember to approach each and every EKG systematically. Grab your calipers, and let’s get started!

First off, what do you see?

2/ For those of you who spotted the prolonged QT, how did you spot it? Do you have a preferred formula for calculating the QTc?

For our previous post on TDP/PVT, click the link: coreimpodcast.com/2018/03/08/60m…

3/ All of us have used the Bazett formula, even if we’ve never seen it before - this is what the computer uses to spit out a QTc at the top of your printout.

Now, what’s your differential for prolonged QT? How do you prioritize that ddx given the patients HPI and PMH?

4/ Our patient had profound hypocalcemia, and likely received some QT-prolonging meds to try to alleviate her nausea/vomiting.

Once you identify hypocalcemia with prolonged QT, what’s your next step?

5/ These patients need to be triaged appropriately and the use of IV calcium is indicated.

Next question: how does hypocalcemia lead to a prolonged QT interval?

6/ It’s a throwback to that good ol’ cardiac cycle! Go back to the EKG at the top of the post and notice how the QT prolongation is attributable to ST prolongation - pathophysiology in action!

7/ And that’s all for today, folks! Hope you got a chance to put on your thinking caps. Remember: retrieving is learning!

To see today’s post on our website, click the link: coreimpodcast.com/2020/02/27/65f…

/fin