By Sean Henderson

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Mobitz II and third degree AV block) due to injury of the conducting system. These rhythms may not respond to atropine and preparations for external and/or invasive pacing should be made immediately. , first degree AV block or Wenkebach patterns) due to an increase in vagal tone. These are usually transient and responsive to IV atropine. • Tachydysrhythmias increase myocardial oxygen demand and should be treated according to ACLS protocols. • It should be noted that the presence of low-grade ectopy in ACS, such as intermittent premature ventricular contractions (PVCs), is not routinely treated with antidysrhythmic agents as was once common practice.

ST elevations in the vascular territory of a particular epicardial artery (see above) is characteristic of transmural MI, when there is complete obstruction. • Because of the time-dependent nature of revascularization treatments for STEMI, the most important distinction that must be made in the initial evaluation of a patient with symptomatic CAD is that between those patients with significant ST elevation and those without. • Since ST elevation may not be present on the initial EKG, it is important to obtain frequent serial EKGs, especially when there is a dynamic nature to the patients presenting symptoms.

In: Marx JA, Hockberger RS, Walls RM, eds. Emergency Medicine. Concepts and Clinical Practice. Mosby, 2002:2. 6. Murphy C. Hypertensive emergencies. Emergency Medicine Clinics of North America November 1995; 13(4):973-1007. 7. Thach AM, Schultz PJ. Nonemergent hypertension. New perspectives for the emergency medicine physician. Emergency Medicine Clinics of North America November 1995; 13(4):1009-35. 8. Tietjen CS, Hurn PD, Vlatowski JA et al. Treatment modalities for hypertensive patients with intracranial pathology: Options and risks.

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