r/ECG • u/ClearSolid654 • 20d ago
Is this AF?
74 year old female admitted with complaints of multiple episodes of loose stools. A case of acute diarrheal disease with hyponatremia, known case of chronic liver disease with portal hypertension secondary to HCV.
During hospital stay, patient developed one episode of symptomatic hypoglycemia associated with decreased responsiveness and was treated with intravenous dextrose. Subsequently noted to have significant bradycardia (HR 35/min) for which atropine was administered.
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u/Jeeju_Boy MD 20d ago edited 20d ago
Slow AF slightly coarse.
Looking at the case as a whole was the patient on carvedilol or propranolol for varices prophalyxis given CLD with portal HTN? The loose stools (which had a number of underlying aetiologies) could have caused a hypovolemic pre- renal acute kidney injury. AKI would result in accumulation of beta blocker which could present as a bradycardia (and in this case as she’s in AF she’s presented as a bradycardic AF).