A 73 yo F with hx of well-controlled hypothyroidism presented to the Ed, as she was found down, unconscious near a café.
She was successfully resuscitated after requiring emergency treatment for sudden cardiac arrest.
Echocardiogram revealed severe biventricular failure with inferior posterior septal wall motion abnormality. A heart catherization was performed, which showed mild non-obstructive coronary artery disease.
What is the next best step?
- Monitor on telemetry
- Start aspirin
- Obtain cardiac MRI
- Call cardiac electrophysiology consult
A 37 yo F with hx of well-controlled asthma on albuterol prn presented with an erythematous, nonpruritic rash of 1 week duration on her legs and new onset of joint pains. Two days prior to her ER visit, she noted bilateral, left greater than right, ankle pain, redness and swelling. She was afebrile with normal heart rate, blood pressure, and oxygen saturation on room air.
Physical exam was notable for erythematous painful nodules scattered on her lower legs. Ankles had full range of motion with erythema and diffuse soft tissue swelling. No effusion was palpated in joint. Laboratory data revealed elevated inflammatory markers.
What is the next best step?
- Start corticosteroids
- Discharge patient with dermatology followup
- Obtain chest x-ray
- Obtain ankle x-rays