Welcome to Emergency Medicine Cases.com. I'm your host, Dr. Anton Hellman, bringing you Canada's

brightest minds in emergency medicine from EMC Studios in Toronto. This month we're going to do

something a little bit different. Just this past February, I helped organize Whistler's

Update in Emergency Medicine Conference. It was the 25th year anniversary, and this year was one of the

best ever. We had a lot of speakers from emergency medicine cases there, and what I did was

recorded the entire conference. Unfortunately, not all the audio was recorded

properly but of the audio that was recorded properly I added it down to just

the highlights the practical stuff that I thought you could use in your general

everyday practice the nice thing about this conference is that it's pretty small

there about 175 participants so there was a lot of group discussion and small workshops which are great for learning.

So without further ado, we're going to start off with one of Dr. Latovsky's workshops on cardiac cases.

The cases that I'm going to present this morning are cases that you don't see very often.

So the first case is you get a patch, you get a call from EMS. are cases that you don't see very often.

So the first case is you get a patch, you get a call from EMS, but they're bringing in a 58-year-old guy with crushing retryl sternal chest pain.

Five minutes later, they patch again, and they say now on route, he's become extremely short of breath

and he's really become diaphoretic. They say he's got no past medical history and he's on

no medication. So no past history, he was pale, he was clammy, he was really diaphoretic,

he did not look good at all. So you need a stat ECG, and there's the ECG. What is this? An inferior MI, right? It's not a diagnostic dilemma. There's SC segment elevation, 2, 3, and AVF, right? There are SD segment depressions across the antiburial leads. There are no question in our reciprocal leads. So we have an acute inferior MI, but what's this clinical picture? He's an acute

justified failure. Am I right? He's an acute pulmonary. Let's go back to the

cardigan. What doesn't fit? First of all, is this a massive inferior or a smaller

inferior? Are there massive estes segment elevations or are there just a couple of

millimeters in every lead? In fact, you could call this a relatively smallish

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