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Archive for October 2019

Benediction Sign

The Benediction Sign is mistakenly called an Ulnar nerve injury. It is in fact a MEDIAN nerve injury at the level of the Elbow. It occurs as the median nerve supplies the lumbricals 1 and 2, which flex the the first 2 digits at the metacarpophalangeal joints. Another way to test this is to ask…

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ST Elevation in aVR

A 70 year old woman presents with severe shortness of breath and chest pain. She loses output briefly. Her ECG is shown below She has ST elevation in aVR. What is the diagnosis? Read below and then view the angiogram. We diagnosed critical Left Main Coronary Artery(LMCA) obstruction and urgently transferred the patient for angiography and…

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Brugada Syndrome

A 25 year old male presents to the emergency department following a near syncopal episode. His ECG shows a supraventricular tachycardia(SVT). Vagal manoeuvres are attempted, unsuccessfully. Adenosine is then given for reversion. He reverts and his post-reversion ECG is shown below. One of the registrars is concerned that the ECG is showing a Brugada pattern.…

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