Cardiology

EM@3AM: Brugada Syndrome

A 36-year-old female presents to the ED after experiencing an episode of sudden syncope. The patient has no significant past medical history, and reports that she was walking to the end of her driveway to retrieve her mail when she suddenly collapsed to the ground. She recalls waking up on her driveway with concerned neighbors gathered around her. The patient states that this has never happened before. On arrival, she is stable and well-appearing. Exam is normal. ECG demonstrates coved ST segment elevation >2mm in V1-V3 followed by a negative T wave. What is the diagnosis?

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EM@3AM: Aortic Stenosis

An 83-year-old female presents to the ED with dyspnea at rest following a syncopal episode. Patient reports she was out for a walk with her husband when she began to feel lightheaded, short of breath, and then fainted. Triage vitals include BP 88/50, HR 115, RR 24, O2 98%. ECG is without signs of acute ischemia. On exam, the patient appears slightly tachypneic, with rales noted at bilateral lungs. There is a systolic murmur along with 2+ pitting edema at the lower extremities. Cardiac POCUS shows grossly decreased left ventricular EF with a hyperechoic structure at the aortic valve. What is the most likely diagnosis?

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