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  #1  
Old 07-05-2012
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EKG Can you diagnose this EKG!

A 63-year-old female presents to your clinic complaining of palpitations. For the past 3 weeks, she has noticed pounding of her heart that comes and goes. Her symptoms are more frequent at night. Her only medicine is insulin for diabetes mellitus. On physical examination, she is alert and oriented, and in no distress.

Her EKG is shown below

Can you diagnose this EKG!-ekg001.png
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Which of the following best accounts for this patient's symptoms?

A. Sinus arrhythmia
B. Irregularly irregular atrial activation
C. Variable AV node conduction
D. Atrial ectopy
E. Ventricular ectopy
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  #2  
Old 07-05-2012
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C. Variable AV node conduction
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  #3  
Old 07-05-2012
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Default E

I would go with E
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Old 07-05-2012
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Quote:
Originally Posted by Anders View Post
I would go with E
im really not all that good at ekg reading. can you please explain

heres what i thought:-
in the ekg above.. the rate is irregular and the rythm is irregular.
however is not Afib cos you can still see P waves...
and also both narrow and wide complex QRS. (so atrial transmission and ventricular rythm both)
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Old 07-05-2012
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Default Early cycle PVC

Well, my interpretation as follows :
this is PVC that occur in group( 3 , 4 PVC or even more) with R on T phenomenon, in which QRS is superimposed the T wave of preceding beat.
this is a dangerous form of PVC that may progress to VT.

Open to hear other explanation!
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  #6  
Old 07-05-2012
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i think answer is (c) Vriable AV cond.
The ECG contains saw Toothed atrial activity i.e. Typical Atrial flutter Also there are irregular QRS complex (narrow)
And one wideQRS (ectopic) which means that this is an irregular AV conduction
Because of the very fast atrial rhthme. So the best answer is atrial flutter with irregular AV conduction and a single PVC
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  #7  
Old 07-05-2012
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Hi
I would also go with " C ".
The problem appears to be at AV nodal conduction.
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Old 07-06-2012
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Cool

Atrial rate:250-350
sawtooth flutter waves,,narrow QRS,,
SO,,this is atrial flutter with variable block,,the c is correct
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Cool The c is correct

Atrial rate:250-350
sawtooth flutter waves,,narroe QRS,,so it is atrial flutter with variable block
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  #10  
Old 07-06-2012
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Atrial flutter???
B :/
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  #11  
Old 07-06-2012
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ans is C.

in atrial flutter, there is re-entery in atria [ not atrial ectopy] . AV node cannot transmit all flutter impulses to ventricle...so there is AV node conduction delay.
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Cardiology-, EKGs-, Internal-Medicine-, Step-2-Questions

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