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1/ It’s Thursday, #MedTwitter, which means it’s time to take out your calipers and get to business. It’s #12LeadThursday!

Remember to use your system to go through each and every ECG methodically.
2/ Rate: ~75bpm
Rhythm: NSR
Axis: ...
3/ Do you have a schema or framework for thinking about a right axis deviation? What’s your differential?

Let us know in the comments below, and check out the framework we’ve provided!
4/ If you take a very, very close look at the EKG, you’ll start to get some hints, a whiff, of what’s amiss in our 28 y/o patient...
5/ ...and the CXR below confirms our suspicion: dextrocardia (appropriate for #LeftHandersDay, maybe?).
6/ Given our patient’s chief complaint, it’s helpful to remind ourselves what other conditions are associated with dextrocardia.
7/ Thanks as always to @KelseyGrossman for authoring this post and to @gregorykatz for peer review. Graphics by @RahulM_MD.

Check out this post and more on our website: coreimpodcast.com/2020/08/13/28m…
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CORE IM
@COREIMpodcast
1/ Welcome back, #medtwitter, to the latest installment of #12LeadThursday - #covid19 edition! Let’s put those calipers to work!

Take a look at this ECG. Approach it systematically. What do you see?
2/ In the above ECG, you’ve got an irregular narrow complex tachycardia. What’s your final read? Reply with your reasoning!
3/ Let’s take a closer look. In the graphic below, we’ve highlighted what you would expect to see in flutter - and none of it is present here. Our patient is fibbin’ away, folks.
Read 6 tweets
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CORE IM
@COREIMpodcast
1/ Happy Tuesday, #medtwitter! It’s time to take that walk down the hall to radiology for another round of #readingroom - let’s go!
2/ Looking at the previous tweet, where is the abnormal air located?
3/ If you said mediastinum, you’re right! This is also well characterized on chest CT pictured below.

Next question: how on earth did air get into the mediastinum? Reply with your thoughts, differentials and/or schema!
Read 7 tweets
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CORE IM
@COREIMpodcast
1/ Good morning, #medtwitter! This 1 goes out 2 everyone who hasn’t had to interpret a blood gas since Steps, prelim year or their last episode of ER (@DGlaucomflecken).

FYI: this ain’t a course on Winter’s Formula. We’re talking practical vent adjustments today. #covid4MDs
2/ There are 4 variables we might want to adjust on the vent based on our ABG results: PEEP, FiO2, RR and Vt. The first two we adjust to achieve appropriate oxygenation while the latter two we adjust to achieve adequate ventilation.
3/ Now that we’ve had that brief review, take a look at the following gases. What’s the problem, and how might you fix it?

Keep scrolling through the thread for the answers!
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