Carbon monoxide poisoning and its effect on QTc prolongation.

Carbon monoxide (CO) poisoning has been associated with direct toxicity to the cardiovascular system by causing arrhythmias through prolongation of QTc. It has been reported to have arrhythmogenic potential likely due to its action on the cardiac membranes. We present a case of a 69-year-old man who presented to the emergency department for evaluation of a syncopal episode after exposure to CO.

Traumatic Right Coronary Artery Dissection as a Cause of Inferior Wall ST-Elevation Myocardial Infarction.

Blunt cardiac injury, causing coronary artery dissection in the absence of other forms of injury to the heart or lungs is a rare occurrence. Here we present a case of a 41-year-old male who presented with right coronary artery (RCA) dissection after blunt chest trauma. The patient initially presented with chest pain and was diagnosed with an inferior wall myocardial infarction (MI).

Flecainide toxicity in renal failure.

Flecainide, a class Ic antiarrhythmic, is used for the prevention of paroxysmal supraventricular tachycardia, paroxysmal atrial fibrillation/flutter, and sustained ventricular tachycardia. Flecainide is primarily metabolized by the liver and to a lesser extent (30%) is excreted unchanged in the kidney. We present a case of flecainide toxicity in the setting of renal impairment that was successfully treated with intravenous sodium bicarbonate.

Are those premature ventricular complexes?!

Ventricular parasystole has been known to be a benign rhythm. We present a case of a 53-year-old man with chest pain and ventricular parasystole on electrocardiogram upon initial presentation. He was admitted and found to have normal serial cardiac enzymes and nuclear stress testing.