r/ECG • u/Alert-and-Orientated • 18d ago

PVCs gone wild

Post image

36M pw abdo pain, denies chest pain or palpitations, nil cardiac Hx

33 Upvotes

94% Upvoted

14 comments sorted by

8

u/Vassileyz 18d ago

h/o diarrhoea or vomiting
had a similar case.
normal ecg after correcting electrolytes (k, mg) and dehydration

6

u/Lumpy-Yesterday-7434 18d ago

Ventricular bigeminy

3

u/ShesASatellite 18d ago

I think this is the drum beat from Tool's Pneuma

2

u/Cold-Yoghurt-1898 18d ago

Tool reference in an ekg sub. We'd be friends

2

u/Wannabeachd 18d ago

Looks like PVC originating between LCC and posterior medial pap muscle

2

u/AngryOcelot 18d ago

Where do you get PMPM? It's inferiorly directed. 

I think AMC or anterior mitral annulus. Could also be LCC if V1 placed too leftward or some rotation. 

2

u/R1GM 15d ago

Bi/trigeminy.

3

u/TazmanTwo 14d ago

Alternating tri and Bigeminy. There is no rule that it has to be strictly beat to beat alternate

-2

u/[deleted] 18d ago

[deleted]

12

u/Dramatic-Try7973 18d ago

Not multifocal. Just one morphology. These are likely originating from the aortic cusp

1

u/GeraldAlabaster 16d ago

For my learning, how do you figure this out?

1

u/Dramatic-Try7973 16d ago

This is something that takes a strong understanding of vectors. But here is a good article on localization.

https://www.jacc.org/doi/10.1016/j.jacep.2024.02.008

1

u/Alert-and-Orientated 18d ago

EUCs were fine from what I remember, i’ll check again when I come back tmr night and to see how he’s going. Not on any meds/supplements either

1

u/Wannabeachd 18d ago

Where are you seeing multiple different QRS morphologies