Point-of-Care Ultrasound Scientific and Case Reports Session 5
COming Out Of Nowhere: Carbon Monoxide Poisoning Related ST-Segment Elevation And Rapid Evaluation With Point Of Care ECHO.
Wednesday, April 10, 2024
8:02am – 8:09am
Location: 410
Authors: Gavin Rogers, Eastern Virginia Medical School Jared Lausen, Eastern Virginia Medical School Sara Demian, EVMS Emergency Medicine Residency Kean Feyzeau, Eastern Virginia Medical School Barry Knapp, Eastern Virginia Medical School Donald Byars, Eastern Virginia Medical School ,
An otherwise healthy 27 year old male presented to the emergency department with progressive lightheadedness and shortness of breath after carbon monoxide (CO) exposure. The patient had ST-segment elevations with reciprocal depressions on electrocardiogram (ECG) concerning for ST-segment myocardial infarction (STEMI). Rapid point of care echocardiogram performed by an EM resident with cardiology attending and EM ultrasound fellow present at bedside found normal systolic and diastolic function with no regional wall motion abnormalities (RWMA) which allowed for deescalation of STEMI protocol. A full cardiac workup was performed while the patient remained in emergency department observation and received treated with supplemental oxygen. His workup was ultimately reassuring and after seven hours of supplemental oxygen the patient had resolution of his ECG changes and symptoms. This case highlights unique ECG changes found in CO poisoning as well as the utility of POC echocardiogram to prevent unnecessary percutaneous intervention in an otherwise healthy 27 year old patient.