Scenario: This electrocardiogram (ECG, unchanged from 1 year prior) is from a 67-year-old man who arrived in an emergency department with increased shortness of breath (SOB). He had been having progressive SOB for the past 2 weeks with associated swelling of both legs. His medical history includes heart failure and lambda light chain amyloidosis (diagnosed in 2007) affecting the heart and tongue. He had a stem cell transplant in 2008, at which time he had a normal cardiac ejection fraction, but his amyloidosis recurred. Since then, he has had frequent visits to the emergency department with exacerbation of the heart failure. His medications consisted of acyclovir, eplerenone, and furosemide. Vital signs and laboratory test results were within normal limits except his respiratory rate was elevated at 22/min, oxygen saturation was 90%, body mass index was 20.5, and his brain natriuretic peptide level was 1300 pg/mL. Chest radiography showed cardiomegaly...
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1 January 2020
ECG Puzzler|
January 01 2020
Electrical Disturbance From a Systemic Disease
Teri M. Kozik, PhD, RN, CNS, CCRN;
Teri M. Kozik, PhD, RN, CNS, CCRN
Teri M. Kozik is director of clinical research–academic affairs at St Joseph’s Medical Center, Stockton, California. Paul Shiu is a fourth-year medical student at Touro University California, Vallejo. Salah S. Al-Zaiti is an assistant professor in the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Mary G. Carey is director for clinical nursing research, Strong Memorial Hospital, Rochester, New York. Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco.
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Paul Shiu, OMS-IV;
Paul Shiu, OMS-IV
Teri M. Kozik is director of clinical research–academic affairs at St Joseph’s Medical Center, Stockton, California. Paul Shiu is a fourth-year medical student at Touro University California, Vallejo. Salah S. Al-Zaiti is an assistant professor in the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Mary G. Carey is director for clinical nursing research, Strong Memorial Hospital, Rochester, New York. Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco.
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Salah S. Al-Zaiti, PhD, RN, CRNP;
Salah S. Al-Zaiti, PhD, RN, CRNP
Teri M. Kozik is director of clinical research–academic affairs at St Joseph’s Medical Center, Stockton, California. Paul Shiu is a fourth-year medical student at Touro University California, Vallejo. Salah S. Al-Zaiti is an assistant professor in the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Mary G. Carey is director for clinical nursing research, Strong Memorial Hospital, Rochester, New York. Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco.
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Mary G. Carey, PhD, RN;
Mary G. Carey, PhD, RN
Teri M. Kozik is director of clinical research–academic affairs at St Joseph’s Medical Center, Stockton, California. Paul Shiu is a fourth-year medical student at Touro University California, Vallejo. Salah S. Al-Zaiti is an assistant professor in the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Mary G. Carey is director for clinical nursing research, Strong Memorial Hospital, Rochester, New York. Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco.
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Michele M. Pelter, PhD, RN
Michele M. Pelter, PhD, RN
Teri M. Kozik is director of clinical research–academic affairs at St Joseph’s Medical Center, Stockton, California. Paul Shiu is a fourth-year medical student at Touro University California, Vallejo. Salah S. Al-Zaiti is an assistant professor in the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Mary G. Carey is director for clinical nursing research, Strong Memorial Hospital, Rochester, New York. Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco.
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Am J Crit Care (2020) 29 (1): 77–78.
Citation
Teri M. Kozik, Paul Shiu, Salah S. Al-Zaiti, Mary G. Carey, Michele M. Pelter; Electrical Disturbance From a Systemic Disease. Am J Crit Care 1 January 2020; 29 (1): 77–78. doi: https://doi.org/10.4037/ajcc2020148
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