Congratulations to Itamar for the best answer and discussion with kudos to Dr. Ben Kaufman as well for the first answer! This is atrial fibrillation with Wolff-Parkinson-White Syndrome (WPW). Itamar gave a very good discussion of wide-complex tachycardias. In our patient, the differential is indeed narrowed down by the Read more…
31 yo M presents to your Emergency Department with palpitations and shortness of breath. His EKG is below: 1. What is the interpretation? Rate, rhythm, axis, intervals, etc…. 2. What is the emergent and subsequent treatment? Best answer by 8/21/15 at noon will be the winner!
Rhythm Nation May 2015 Answer Congratulations to Dr. Reza Roodsari! This is indeed a case of digoxin toxicity. Whenever you see “regularized a-fib,” that is, regular QRS intervals in a patient with permanent atrial fibrillation, think digoxin toxicity until proven otherwise. What happened to this patient? Due to high digoxin level, this Read more…
67 yo F with permanent atrial fibrillation. Why is her rhythm regular? Best answer by May 18th at noon is our winner!
Excellent interpretation by Dr. Tepler! Exactly right, bradycardia and Osborn waves were concerning for a cold patient – in this case had moderate hypothermia. The Osborn wave (aka J wave) is seen in a variety of conditions. It can be a normal variant, but with the combination of bradycardia other Read more…
You are handed this ECG and immediately get up to go see this new patient … why? What are you worried about? Best answer by Friday 4/17/15 at noon is our winner!
Rhythm Nation March 2015 – Answer! Congratulations to VTACHomas for being first! Excellent discussion from JFreedman and Eschnitz. This is a complicated ECG! Let’s first look at the option of ventricular bigeminy. Ventricular bigeminy has recurring premature ventricular contractions (PVCs) after every atrial sinus beat. There is then a Read more…
26 yo M pmh multiple episodes of syncope as child p/w anxiety symptoms for months. No meds or illicits. His father died at age 39. He has the following dysrhythmia: Questions: What is this rhythm? What is your ED care and dispo? Best answer by March 23 Read more…
Kudos go to Dr. Bryan Jarrett for an excellent interpretation! Much discussion was had over this ECG. There is an AV dissociation where the P waves march out. There is a slightly wide QRS, but not that wide. There is a small variability in the morphology of the Read more…
50 yo F pmh ESRD, CHF presents with one day of “feeling bad.” HR 170s, received adenosine for suspected AVNRT and the rate “broke” into this ECG seen below: Your only question… what could this rhythm be, and why? Due to the inservice next week, you have Read more…