Rhythm Nation: Case 1

Here is this weeks EKG!  Post your reading and your plan in the comments.  I’ll post the answer next week!

The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.
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nchristopher

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5 comments for “Rhythm Nation: Case 1

  1. doty
    August 10, 2012 at 7:47 am

    Very interesting. The QRS morphology is interesting. It reminds me of something I read recently…..I just can’t put my finger on it. It looks similar but just a little different.

  2. Ian deSouza
    August 10, 2012 at 12:51 pm

    What was the clinical presentation?

  3. mritchie
    August 10, 2012 at 4:30 pm

    She presented with episodes of palpitations for months on and off. No other symptoms.

  4. Ian deSouza
    August 12, 2012 at 6:07 pm

    Ectopic atrial tachycardia with 2:1 conduction (and 1st degree AV block).

    Nodal blockade for presentations which involve rapid ventricular rates. EP study with ablation for definitive management….

  5. bberzon
    August 15, 2012 at 2:50 pm

    Dr.deSouza,
    It seems like the 2 P’s are of different (minor) morphology. In fact it seems like the P right after the qrs is a retrograde P originating from the ventricle. Could it be that there is a loop/accessory pathway and that that is the cause of the occasional sensations of palpitations? doesn’t change the fact that she needs EP study and ablation.
    Thanks Baruch

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