Thank you, Tim, for presenting the case of a middle-aged man with CAD presenting with ankle pain and chest pain, admitted for high risk chest pain, noted to have acute onset of hypotension, bradycardia, hypoxemia, and decreased mental status in the setting of receiving multiple antihypertensive medications.
- 6 Ps of ischemia: pain, pallor, parasthesias, poikilothermia, pulselessness, paralysis.
- Over 75% of patients with peripheral arterial disease have significant coronary artery disease, hence why presence of PAD is considered a risk factor equivalent for CAD.
- Hyperkalemia is a cause of bradycardia, especially when combined with AV nodal blockade! See BRASH syndrome below.
- Renal injury
- AV node blocker: beta-blocker, verapamil, or diltiazem (2)