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ECG Abnormalities_Part 12

Sunday, November 7, 2010

A 68 year old male with a past history of chronic atrial fibrillation presents to the emergency room with a complaint of nausea, vomiting, generalized abdominal pain, and generalized weakness. No fevers or chills. No diarrhea, constipation, melena, or other signs of gastrointestinal bleeding. He does not know his medications. He states his vision has been slightly yellow tinged recently.

His temperature is 37.0, blood pressure 90/50, heart rate 55, respiratory rate is 16. No jugular venous distension is present, he is bradycardic and irregularly irregular on cardiac exam without any murmurs. His lungs are clear to auscultation. His abdominal exam is completely normal. The rest of his exam is normal.

His ECG is below:

 Identify the Abnormality?


The ECG findings include:

1) atrial fibrillation with bradycardia
2) ST segment depression consistent with digoxin effect

The ECG shows a downsloaping ST segment depression in multiple leads that are shaped like the "reverse check mark sign" or a "scooped out" appearance. This pattern is typical of digoxin. This may occur at normal digoxin levels in some people, but becomes more common as the digoxin level increases.


12 Responses to ECG Abnormalities_Part 12

  1. Anonymous Says:
  2. digoxin toxicity

  3. Anonymous Says:
  4. digoxin intoxication : odded shaped ST depress (not interplete by wall) and clinical Nly

  5. Anonymous Says:
    Irregular pulse
    Loss of appetite
    Nausea, vomiting, diarrhea
    Visual changes (unusual)
    Blind spots in vision
    Blurred vision
    Changes in color perception
    Halos or rings of light around objects
    Seeing lights or bright spots
    Additional symptoms that may be associated with digitalis toxicity include:
    Decreased consciousness
    Decreased urine output
    Difficulty breathing when lying down
    Excessive nightti

  7. Anonymous Says:
  8. Digoxin toxicity

  9. Anonymous Says:
  10. Depression S-T, wave T negative, Extrasystoles ventricularis

  11. Anonymous Says:
  12. digitalis intoxication ( refer wikipedia)

  13. Wolf-parkinson-white syndrome

  14. Anonymous Says:
  15. digitalis intoxication

  16. Chris Says:
  17. Digoxin Toxicity

  18. Danf Says:
  19. Agree with Chris on Digoxin Toxicity!

  20. Anonymous Says:
  21. atrial tachy with AV block

  22. Anonymous Says:
  23. digoxin toxicity


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