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ECG Abnormalities_Part 19

Wednesday, April 27, 2011

 You are the house officer on call for the telemetry floor and a nurse calls you with an abnormal rhythm seen on telemetry. The patient was admitted 2 days previously for a congestive heart failure exacerbation. He denies any symptoms including chest pain, palpitations, lightheadedness, or shortness of breath. Vital signs are normal. You ask for a 12-lead ECG which is below:


You go back to sleep and are soon called again for another abnormal rhythm seen on the same patient which is intermittently occurring. The patient is still asymptomatic and vital signs are still normal. Another 12-lead ECG is obtained which is below:


What are the ECG abnormalities?


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40 Responses to ECG Abnormalities_Part 19

  1. Anonymous Says:
  2. VT

     
  3. Anonymous Says:
  4. 1st AF
    2nd VT

     
  5. Anonymous Says:
  6. VT

     
  7. Anonymous Says:
  8. taquicardia ventricular

     
  9. 1) flutter auricular
    2) taquicardia ventricular

     
  10. Anonymous Says:
  11. the first is atrial flutter the second is ventricular tachycardia

     
  12. Anonymous Says:
  13. ventricular tachycardia...........????idioventricular rhythm

     
  14. Anonymous Says:
  15. first one is suggestive of hypokalaemia, which may be is induced by diuretics used for CCF and second is suggestive of Paroxysmal supraventricular tachycardia.... may be induced my severe hypokalaemia.....

     
  16. Anonymous Says:
  17. Atrial Flutter for the first then ven tachy

     
  18. 1. Atrial Flutter with 2:1 AV Block
    2. Ventricular Tachycardia with Right Bundle Branch Block

     
  19. Anonymous Says:
  20. 1. Atrial flutter
    2. Non sustained VT

     
  21. Anonymous Says:
  22. Ventricular tachycardia with branch block

     
  23. Anonymous Says:
  24. 1st is A.flutter with 2:1 AVB then VT

     
  25. Anonymous Says:
  26. VT

     
  27. Anonymous Says:
  28. 1. broken humerus
    2. obstipation

     
  29. Anonymous Says:
  30. A. Flutter, V Tach. Dig. Toxicity low K

     
  31. Anonymous Says:
  32. first one is atrial flutter.
    second one is VT

     
  33. Anonymous Says:
  34. 1st ecg hypokalemia ...2nd one pvc

     
  35. Anonymous Says:
  36. Atrial flutter fibrillation with SVT /bundle branch block or VT(not sure
    )

     
  37. Anonymous Says:
  38. the first is atrial flutter the second is ventricular extrasystol triplet

     
  39. Anonymous Says:
  40. pvc

     
  41. Anonymous Says:
  42. 1st is ATRIAL FLUTTER N 2ND IS VT

     
  43. Anonymous Says:
  44. sinus tachychardia.vT

     
  45. Anonymous Says:
  46. VT

     
  47. marwacardio Says:
  48. vt

     
  49. Anonymous Says:
  50. first ecg is atrial flutter called tooth saw rythm.and in second ecg there is run of pvcs just like vt

     
  51. Anonymous Says:
  52. 1.prolonged QT
    2.VT

     
  53. Anonymous Says:
  54. 1)Prolonged QT
    2)Vt

     
  55. 1- atrial flutter
    2- non sustain vt

     
  56. Anonymous Says:
  57. The first is SR @ 84 bpm, normal axis, early transition of precordial leads in V2, but most importantly a U wave seen in all leads which may indicate an electrolye imbalance (K+). Specifically Hypokalemia.

    The second 12 lead EKG also has a normal axis (even with the wide complex tachycardia. V1 shows the narrow complex as a RBBB patern which is new from the previous ECG, and a LBBB pattern with the wide complex tachycardia. Additionally, the wide complex tachycardia shows negative in V1 with no "fat R-wave, notched or slurred QS, and a positive complex in V6. I do not beleived that this is VT. I think the patient is blocking in the bundle branches depending on the rate. When the patient goes into SVT, the rate is fast and a LBBB is the result.

    #1 - SR with U waves.
    #2 - Aberrantly conducted SVT.

     
  58. Anonymous Says:
  59. 1. fluter auricular
    2. TV no sostenida.

     
  60. Anonymous Says:
  61. First one is tremor artifact. 2nd ecg shows non sustained VT

     
  62. Anonymous Says:
  63. flutter auricular
    taquicardia ventricular no sostenida

     
  64. Anonymous Says:
  65. V tach

     
  66. Anonymous Says:
  67. Isn't it torsade de pointes?

     
  68. Boris Says:
  69. 1st U-waves and prolonged QT
    2nd ventricular tachicardia

     
  70. Anonymous Says:
  71. VT

     
  72. Anonymous Says:
  73. FIRST IS ATRIAL FLUTTER SECOND IS PVC

     
  74. Hi, Really great effort. Everyone must read this article. Thanks for sharing.

     
  75. These tips are very useful for me and for that really thanks for sharing with us.

     

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