1/2/2023 0 Comments Lvh with ivcd![]() ![]() Past medical history was significant for type 2 diabetes, hypertension, hyperlipidemia, and chronic kidney disease. Rhythm strips from an 88-year-old female with a dual-chamber pacemaker who presented after three syncopal episodes within 24 hours. Past medical history was significant for type II diabetes, hypertension, hyperlipidemia, and chronic kidney disease (CKD). When this occurs, the change in R-R interval precedes and predicts the change in P-P interval in other words, the R-R change drives the P-P change, confirming that this is VT with 1:1 VA conduction.įigure 5: An 88-year-old female with a dual-chamber pacemaker presented after three syncopal episodes within 24 hours. However, there is subtle but discernible cycle length slowing (marked by the *). There appears to be 1:1 association (best seen in leads II and aVR as a deflection on the down slope of the T wave) which, by itself, is not helpful. The QRS complex down stroke is slurred in aVR, favoring VT. The QRS complex in lead V1 shows an rS pattern, with a broad initial R wave, favoring VT (Table V). The QRS duration is 170 ms the rate is 126 bpm. ![]() Representative ECG from a 57-year-old woman with palpitations for many years and idiopathic globally dilated cardiomyopathy was admitted for incessant wide complex tachycardia. The QRS morphology suggests an old inferior wall myocardial infarction, favoring VT.ĮCG findings to help distinguish causes of WCT when the QRS complex in V1 is terminally upright – RBBB-like morphologyįigure 4: A 57-year-old woman with palpitations for many years and idiopathic globally dilated cardiomyopathy was admitted for incessant wide complex tachycardia. The QRS complex in lead V1 shows an Rr’ morphology (first rabbit ear is taller than the second), favoring VT (Table IV). Lead aVR shows a broad Q wave, favoring VT. There is precordial (positive) concordance, favoring VT. The frontal axis superiorly directed, but otherwise difficult to pin down. The QRS complex is wide, about 150 ms the rate is about 190 bpm. Initial ECG from a 70-year-old woman with prior inferior wall MI who presented with an episode of syncope resulting in head laceration, followed by spontaneous recovery by persistent light-headedness. A 70-year-old woman with prior inferior wall MI presented with an episode of syncope resulting in lead laceration, followed by spontaneous recovery by persistent light-headedness. As expected, the P waves are of low amplitude in hyperkalemia.įigure 3. There is a suggestion of a P wave prior to every QRS complex, best seen in lead V1, favoring SVT. The down stroke of the S wave in leads V1 to V3 is swift, <70 ms, favoring SVT with LBBB. There are impressively tall, peaked T waves, best seen in lead V3, as expected in hyperkalemia. The precordial leads show negative complexes from V1 to V6-so called “negative concordance”, favoring VT. The QRS complexes are wide, measuring about 200 ms the rate is 125 bpm. Her serum potassium was 7.1 mEq/dl, and with aggressive treatment of hyperkalemia, her ECG normalized. The ECG in Figure 2 was obtained upon presentation. ![]() She had missed her last two hemodialysis appointments. Figure 2.Īn ECG from a 56-year-old woman with end-stage renal disease who presented with dizziness and altered mental status. She has missed her last two hemodialysis appointments. A 56-year-old woman with end-stage renal disease presented with dizziness and altered mental status. The normal QRS complex during sinus rhythm is “narrow” (40 ms, favoring VT.įigure 2. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |