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EKG help
Started by chocomorsel
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How much hydroxychloroquine did he get? 
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deleted875186
Not sure, could just be sinus tachycardia with a biphasic t wave in lead II making it look funny.
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deleted875186
Have heard of several patients developing heart block in acute Covid infections.
Proceed in I and V1-V6, avoid hypoxia, hypotension and tachycardia.
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deleted59964
given our incomplete understanding of COVID I'd be a bit cautious.
tachycardia and inferior TWI (or biphasic) -- has he got RV strain?
a TTE would be good
what's the case?
things like this ... https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31182-X/fulltext ... are concerning
tachycardia and inferior TWI (or biphasic) -- has he got RV strain?
a TTE would be good
what's the case?
things like this ... https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31182-X/fulltext ... are concerning
Maybe i suck balls but i only see a sinus rhythm.
This is not a surgical case. It’s a floor IM case.
Man, I’m no expert either but I’m not convinced this isn’t sinus tach??? Seems a little slow for 2:1 flutter
Looks like sinus tachycardia to me, but I'd be interested if he's a steady 120 or has variability. Also if you're really unsure you can just give some adenosine and try to slow down the AV node to unveil flutter waves.
V1 P wave morphology is important
"
Typical Atrial Flutter (Common, or Type I Atrial Flutter)
Involves the IVC & tricuspid isthmus in the reentry circuit. Can be further classified based on the direction of the reentry circuit (anticlockwise or clockwise):
Anticlockwise Reentry: Commonest form of atrial flutter (90% of cases). Retrograde atrial conduction produces:
litfl.com
V1 P wave morphology is important
"
Typical Atrial Flutter (Common, or Type I Atrial Flutter)
Involves the IVC & tricuspid isthmus in the reentry circuit. Can be further classified based on the direction of the reentry circuit (anticlockwise or clockwise):
Anticlockwise Reentry: Commonest form of atrial flutter (90% of cases). Retrograde atrial conduction produces:
- Inverted flutter waves in leads II,III, aVF
- Positive flutter waves in V1 – may resemble upright P waves
- Positive flutter waves in leads II, III, aVF
- Broad, inverted flutter waves in V1"
Atrial Flutter
Atrial flutter is a type of supraventricular tachycardia caused by a re-entry circuit within the right atrium
litfl.com
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Are you sure those aren't just inverted T waves? The QT interval is the same in II/III/aVF and Lead 1
Looks like sinus tach with biphasic T waves in the inferior leads
It is paroxysmal and no one tried any vagal maneuvers to slow it down. It popped back to NSR on its own.
looks like sinus tach....any PE concerns?
You have a NSR ekg for comparison?
Man, if that's 2:1 flutter then I'm just gonna resign myself to missing it 100% of the time unless the ventricular rate is 150 bpm
No PE concerns. Back in SR now and doing fine. SOB with the abn. rhythm resolving after return to normal sinus..
My cards buddy thinks its Flutter with poor R wave progression. Says I need a "high quality ECG" to tell PAT from Aflutter.
Is that some special type of ekg or just telling the tech to actually run the study when the pt isn't moving around and talking?
I have no earthly idea. Had to ask him and waiting on a response. Never heard of that.
It's also slower than what you'd expect out of Aflutter.
Looks like sinus tach to me. Could you ask your cards buddy what about this makes it PAT vs AFlutter?
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deleted875186
I’ve changed my mind. Definitely look like flutter waves or some sort of SVT.
Sinus tachycardia. Let's not complicate life.
