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  #1  
Old 08-04-2011
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EKG Retrograde P Waves in the ECG!

A 69 year old female is in the hospital for digitalis toxicity. Her blood pressure is 150/95 and her heart rate is 50 beats per minute. Her ECG shows QRS complexes that are not preceded by a P wave. These are normal looking QRS complexes, but they are not preceded by a P wave. There are retrograde P waves appearing after the QRS complex. What is the most appropriate description of the ECG findings?
a) First degree AV block
b) junctional rhythm
c) sinus bradycardia
d) atrial flutter
e) Ventricular premature beats
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  #2  
Old 08-04-2011
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hmmm, i am guessing Ventricular premature beats
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  #3  
Old 08-05-2011
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b) junctional rhythm ?
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Old 08-05-2011
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A.first degree AVB
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Old 08-05-2011
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Quote:
Originally Posted by akua View Post
A.first degree AVB
ya even i was initially thinking the same, as dig causes av blockade, but i am not sure...that an av block can appear as a qrs preceding a P wave....
<cant remember actually>
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Old 08-05-2011
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I agree

C i think so , i have same scenarrio in D.I.T videos ..its gonna b sinus bradycardia sure
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Old 08-05-2011
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i think JUNCTIONAL RHYTHM....
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Old 08-05-2011
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E. Ventricular Premature Beats.
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Old 08-05-2011
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i m with e but not sure....
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Old 10-31-2011
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I choose b.

Impulse in junctional rhythm origins from AV node, it conducts both upward and downward, so the atrium can still contract sometimes.

It usually presents without a P wave or with an inverted P wave. Occasionally the P wave will be retrograde, meaning appearing after the QRS complex.

a) First degree AV block is wrong because in this case, p wave still appear before every QRS, only that the PR interval prolongs.

c) sinus bradycardia is wrong because 'sinus' means the origin of impulse is from SA node, although interval between 2 p waves prolongs

d) atrial flutter is wrong because in this case you can see the characteristic sawtooth appearance

e) Ventricular premature beats is wrong because in this case the impulse origins from ventricle itself, so QRS should be wide and abnormal.
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Old 10-31-2011
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it is junctional rhythm as i have solved a similiar question before
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Old 11-01-2011
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A 69 year old female is in the hospital for digitalis toxicity. Her blood pressure is 150/95 and her heart rate is 50 beats per minute. Her ECG shows QRS complexes that are not preceded by a P wave. These are normal looking QRS complexes, but they are not preceded by a P wave. There are retrograde P waves appearing after the QRS complex. What is the most appropriate description of the ECG findings?
a) First degree AV block
b) junctional rhythm
c) sinus bradycardia
d) atrial flutter
e) Ventricular premature beats
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