MetHarlem EM Residency

Resident account for the MetHarlem EM residency. Tweets are not to be considered medical advice or representative of NYCHHC.

[Dr sthanu subramanian @drsthanus]

BUN:Cr Ratio

Normal Ratio:

Typically 10:1 to 20:1.

*Increased Ratio (>20:1):

Suggests prerenal causes such as dehydration, hypotension, or congestive heart failure, where urea reabsorption increases disproportionately to creatinine.

*Decreased Ratio (<10:1):

May suggest intrinsic renal problems (like acute tubular necrosis), severe liver disease, or starvation.

https://t.co/ujAY1Xhrkg

[The Medics🩺💊💉🏥 @DrArslan480]

Chest Pain Evaluation

[Ahmed Ata @Ahmedata7777]

Premature Ventricular Contractions (PVCs)

Premature Ventricular Contractions (PVCs) are early heartbeats originating from the ventricles instead of the atria. PVCs are categorized based on their origin, morphology, frequency, and pattern. Here's a breakdown of the types of PVCs seen on ECG:

🔹 1. Based on Morphology:

》Unifocal PVCs

▪︎All PVCs look the same (same shape and axis).
▪︎Originate from a single ectopic focus in the ventricles.

》Multifocal PVCs

▪︎PVCs have different shapes (different morphologies).
▪︎Arise from multiple ectopic foci.
▪︎Often considered more concerning than unifocal.

🔹 2. Based on Frequency:

》Occasional: Few PVCs seen (e.g., <6 per minute).

》Frequent: More than 6 PVCs per minute.

》Bigeminy: Every normal beat is followed by a PVC (normal–PVC–normal–PVC).

》Trigeminy: Every third beat is a PVC

》Quadrigeminy: Every fourth beat is a PVC.

🔹 3. Based on Timing/Pattern

》Interpolated PVC
▪︎A PVC that occurs between two normal beats without a compensatory pause.
▪︎Often seen when the PVC doesn’t disrupt the SA node.

》Couplets
▪︎Two consecutive PVCs.

》Triplets
▪︎Three consecutive PVCs (can be a short run of ventricular tachycardia).

》Run of PVCs / Non-sustained Ventricular Tachycardia (NSVT)
▪︎Three or more PVCs in a row, lasting <30 seconds.

🔹 4. Based on QRS Morphology

》Left Bundle Branch Block (LBBB)–like morphology
▪︎Indicates the PVC arises from the right ventricle.

》Right Bundle Branch Block (RBBB)–like morphology
▪︎Indicates the PVC originates in the left ventricle.

🔹 5. R-on-T Phenomenon

▪︎PVC that falls on the T wave of the preceding beat.
▪︎Dangerous, as it can trigger ventricular fibrillation or torsades de pointes.

PVC Characteristics on ECG:

▪︎Wide QRS complex (>120 ms)
▪︎No preceding P wave
▪︎ST-T discordance (T wave is in opposite direction of the QRS)
▪︎Compensatory pause typically follows (the SA node fires on time, but the PVC delays the next beat)

[AbdAllah Othman @CardioBeat_]

Essential correlation between ECG leads and coronary anatomy.
https://t.co/ozs58couRR
#Cardiology #ECG #EKG #STEMI #MI #HeartAttack #MedicalEducation #ClinicalPearls #MedStudent #FOAMed

[Dr Honey choudhary 🩺 @Doctors__squad]

CPAP (Continuous Positive Airway Pressure) and BIPAP (Bilevel Positive Airway Pressure) are both types of non-invasive ventilation therapies used primarily to treat sleep-related breathing disorders like sleep apnea, but they can also help in other respiratory conditions.

[CardiovascularCorner @TrackYourHeart]

Atrial Fibrillation Pharmacotherapy

[CardiovascularCorner @TrackYourHeart]

This is the best chest x-ray anatomy guide I’ve ever seen.

[Lama Alghamdi @Ph_LamaAlghamdi]

Cephalosporins 💊

[sonologist Mazen Abdo A @mznljrdy47597]

#ultrasound
#sonologist

[CardiovascularCorner @TrackYourHeart]

Transthoracic Echocardiographic (TTE) Views: A Complete Guide

Understanding TTE views is essential for accurate cardiac imaging. Let’s break down the 5 core views:
1️⃣ Parasternal Long Axis
2️⃣ Parasternal Short Axis
3️⃣ Apical
4️⃣ Subxiphoid
5️⃣ Suprasternal

A thread 🧵

[CardiovascularCorner @TrackYourHeart]

ECG Cheat Sheet: Master 12 Common Cardiac Conditions in One Image

[CardiovascularCorner @TrackYourHeart]

ECG interpretation Basic Quick References

[CardiovascularCorner @TrackYourHeart]

Deadly ECG Patterns

[CardiovascularCorner @TrackYourHeart]

Summary of Arrhythmias

[Oren Gottfried, MD @OGdukeneurosurg]

Scalpel blades

[EM Board bombs @EMBoardBombs]

Learn when and how to perform a lateral canthotomy to prevent blindness in orbital compartment syndrome. A must-know emergency procedure for every EM physician! #Medtwitter #FOAMed
https://t.co/Digs6jtvhs

[Dr sthanu subramanian @drsthanus]

The S1Q3T3 pattern, a significant ECG finding indicative of acute pulmonary embolism (PE).

https://t.co/OwPMHQC6UA

[Dr. AK 🇮🇳 @docakx]

A 🧵 of
🚨ALARM SYMPTOMS
/ RED FLAGS🚩in clinical medicine.

Headache
Neck pain
Backache
Gastric reflux

Add in the red flags if you have more👇

HEADACHE🚩

[Oren Gottfried, MD @OGdukeneurosurg]

Neuro exam