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ECG Abnormalities_Part 11

Friday, November 5, 2010

A 38 year old female presents to the emergency department with a complaint of palpitations for 2 hours. She complains that she has intermittently had palpitations for years, but always lasting for minutes only. These palpitations are associated with mild dizziness and shortness of breath. No chest pain occurs.

Her temperature is 37.0, blood pressure 90/50, heart rate 190, respiratory rate is 16. No jugular venous distension is present, she is tachycardic and regular on cardiac exam without any murmurs. Her lungs are clear to auscultation. The rest of her exam is normal.
Identify this ECG rhythm?


ECG ANSWER

The ECG findings include:

Narrow complex tachycardia - most likely AV nodal rentry tachycardiaa (AVNRT)

The ECG shows a narrow-complex tachycardia that is regular.No flutter waves are seen. In leads V3 - V6 a P wave can be seen just after the QRS complex making this rhythm a "short-PR" tachycardia. Remember the most common short-PR tachycardia is AV nodal rentry tachycardia.


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33 Responses to ECG Abnormalities_Part 11

  1. Anonymous Says:
  2. atrial tachycardia

     
  3. Anonymous Says:
  4. atrial flutter

     
  5. Anonymous Says:
  6. supraventricular paroxysmal tachycardia

     
  7. Anonymous Says:
  8. SVT

     
  9. Anonymous Says:
  10. Atrial tachycardia

     
  11. Anonymous Says:
  12. in this case its defficult to distinguis btween atrial fulter and SVT so we give a trial of adenosine if an AV block was evident then this is an A.flutter if it returned to sinus rythem this is SVT sinus tachy is propably not part of the DDX due to bizzar P wave.

     
  13. Anonymous Says:
  14. taquicardia paroxistica supraventricular

     
  15. Anonymous Says:
  16. cold and flu DR.S

     
  17. Anonymous Says:
  18. SVES

     
  19. Anonymous Says:
  20. AV nodal reentry tachy

     
  21. Anonymous Says:
  22. svt

     
  23. Anonymous Says:
  24. svt

     
  25. Anonymous Says:
  26. SVPT

     
  27. Anonymous Says:
  28. psvt

     
  29. Anonymous Says:
  30. atrial tacchycardia(svt?!)

     
  31. Anonymous Says:
  32. svt

     
  33. Anonymous Says:
  34. tachycardie jonctionnelle

     
  35. Anonymous Says:
  36. Svt,am i correct

     
  37. Anonymous Says:
  38. atrial flutter

     
  39. Anonymous Says:
  40. Adenosin Test

     
  41. Hazem Says:
  42. SVT

     
  43. Anonymous Says:
  44. supra ventricular tachycardia with ischemic changes ST depression and T wave inversion in leads V3 - V6 and aVl

     
  45. Anonymous Says:
  46. SVT coz ECG showing regularly regular rhythm with absent P waves .whereas in Atrial Flutter P wave should be like sawtooth.atrial flutter is wrong while SVT is right answer

     
  47. Anonymous Says:
  48. svpt

     
  49. Anonymous Says:
  50. SVT

     
  51. supraventricular tachycardia

     
  52. Anonymous Says:
  53. SVT, hands down. Administer Adenocard to see if there's an underlying cause.

     
  54. Anonymous Says:
  55. It's a 2:1 Atrial flutter. The F waves are most visible in V3 - V6.

    Treatment would be aimed at first, slowing down the rate with Cardizem @ 0.25mg/kg IVP (slow). Then a Cardizem gtt @ 5-15mg/Hr. Ultimately, the pt will need to be sedated and cardioverted if the pt does not convert on thier own.

    You don't need to administer Adenosine because it is clearly A-Flutter. Go ahead if you feel the need, but it is not SVT, PSVT, AVRT, AVNRT.

     
  56. Anonymous Says:
  57. SVT....although I see how some could say that it's A-flutter looking at this ECG, there is no way to truly tell until you slow the rate down. If you slow it down and you have the sawtooth, great, go with your cardizem. If it's not, the adenosine should work. If all else fails, cardiovert.

     
  58. Anonymous Says:
  59. I totally agree with Anonymous (2 above). It is CLEARLY a 2:1 Atrial Flutter where you can see the flutter waves (F-Waves) in V3 - V6....Done.
    Cardizen @ 0.25mg/kg to slow the rate and then a maintenance gtt of 5-15mg/Hr.

     
  60. Anonymous Says:
  61. PSVT

     
  62. Anonymous Says:
  63. PSVT (AVNRT). Therapy is Adenosine 6mg (+12mg +12mg if needed).

     
  64. Anonymous Says:
  65. short RP Tachycardia

     

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