J Emerg Med
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Review Case Reports
Electrocardiographic manifestations: ventricular tachycardia.
Ventricular tachycardia is a serious rhythm disturbance that originates from any part of the myocardium or conduction system below the atrioventricular node. Ventricular tachycardia (VT) presents with a wide QRS complex and a rate greater than 120 beats/min. Ventricular tachycardia is frequently encountered as a complication of coronary artery disease or cardiomyopathy; furthermore, VT is also seen in patients with medication adverse effect or electrolyte disturbance. ⋯ As is true in most Emergency Department presentations, the Emergency Physician must approach the dysrhythmic patient from an undifferentiated perspective, in this instance, the wide complex tachycardia (WCT) scenario. The electrocardiographic differential diagnosis of WCT classically includes VT and supraventricular tachycardia with aberrant intra-ventricular conduction. This article will review the electrocardiographic presentations encountered in patients with ventricular tachycardia.
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Clonidine and the imidazolines, commonly found in topical ophthalmic and nasal decongestants, are chemically related drugs that have been responsible for many pediatric poisonings. These medications can cause significant morbidity in small doses. A review of the available literature reveals that young children have exhibited severe signs and symptoms after ingesting as little as one to two clonidine tablets or 2.5 ml of a topical imidazoline product. ⋯ Signs and symptoms develop rapidly, within 4-6 h. Care is supportive. Death is rare, but many poisoned patients require monitoring in an intensive care setting.
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Review Case Reports
Lymphocytic vasculitis associated with the anthrax vaccine: case report and review of anthrax vaccination.
Anthrax is caused by the spore-forming bacteria Bacillus anthracis. It occurs naturally, but recently has been manufactured as a biological warfare agent. ⋯ Side effects to the current anthrax vaccine are usually minor and mainly consist of local skin reactions. Occasionally an unusual complication may occur; a case of a patient with lymphocytic vasculitis temporally associated with the anthrax vaccine is reported.