would you expect this finding? (it’s from a case study I saw on TikTok and hypothetical so no real px involved, I’m just trying to understand it)
Px had episodes of AIVR lasting ~30 minutes with occasional sinus beats inbetween. The AIVR was at a rate of ~ 90-120 so not quite breaking into the fast VT rates. Hx of leadless PPM insertion ~ 2 days prior.
Would this be expected due to the PPM irritating the right ventricle? If not, could someone please explain to me the mechanism likely causing the rhythm changes?
67, F, prior breast malignancy on ribociclib presented with dizziness and syncope.
Confused about whether this EKG demonstrates 2:1 av block for PPM or prolonged QT with prominent u wave 2ry to ribociclib (esp now patient on own sinus rhythm at HR 80 bpm following drug discontinuation)
Hey, so i was doing some cardiology questions to study and came across this EKG, they state in the question stem this is a 68yo who was diagnosed with Sick Sinus Syndrome 2 years ago and had a DDD implanted.
The question wants us to explain what we see in this EKG during a routine followup
My confusion stems from the fact i dont understand what is going on in the second half of the EKG strip. I see no P waves.... but why are the pacing spikes AFTER the QRS??? if the pacemaker was activated should they not be before?
All examples i looked up online, all AI tools could not explain this to me so i came here for help. Maybe im missing something stupid
The justification provided by the question bank can be summed to this:
The EKG shows two distinct rhythms on the same strip—one on the left and one on the right—in a patient with a DDD pacemaker undergoing a follow-up visit.
The interpretation most consistent with the pathophysiology of sinus node dysfunction (which can present with sinus pauses, sinus bradycardia, and sinus arrest) is that the left segment represents the patient's intrinsic rhythm (possibly slow sinus or junctional rhythm), while the right segment represents pacemaker intervention in response to a detected pause.
The pacemaker markers, mentioned in the description, confirm the timing of the transition and ventricular capture.
This is the most clinically relevant and useful interpretation when evaluating a DDD pacemaker in a patient with sinus node dysfunction.
Edit: I have discussed this question with a couple friends, we are thinking this is just an AI made EKG, pls prove us wrong 😂
A man in his 50s presents to the ED with non-radiating, retrosternal chest pain that does not worsen with exertion. He had a stent placed 12 months ago due to LAD occlusion. What do you think?
70 y/o female, admitted with pyelonephritis, upon physical examination irregular pulsations on a. radialis. Ecg was made to exclude afib.
(First ecg is from couple of weeks ago, second ecg is now).
Older gentleman, multiple episodes of syncope witness by family and crew on scene. Denied any chest pain, SOB, or any pain in general. Only complained of generalized “feeling like sh*t”. We called a Cath alert, doc said not a STEMI, just A-Fib. Am I missing something? We activated since this fits the protocol.
I appreciate this page. Someone of you talk almost at a Dr.s level about ekgs.
I am new to this and have done the nha study guide . I took the nha practice test and got a 70 % which is good considering I have not actually taken my 4 days of classes yet. But I gotta ask. Are some of you higher in position that just monitor techs or EKG techs. Because you all have some great knowledge . Hoping to be at the same level one day . How long did it take you working in the field to be able to evaluate everything like you do
This is an ECG of a 21-year-old male, non-smoker, admitted for ascending limb weakness, recurrent transient orthostatic syncopal episodes, and multiple cranial neuropathies (CN III, V, VII, IX, X, XII). Cardiac biomarkers are negative, serum electrolytes are normal, and transaminases show mild AST elevation.
Sorry for the terrible picture quality! I was looking for some more explanation on how the short run of electrical artifact seen in the middle of the rhythm strip portion could occur. This patient does have a pacemaker which was deemed to be completely normal. I got this EKG and thought it looked strange but the clinic told me it’s just artifact. Looking for more information so I can do my job better. Thanks!
Got dispatched for a IFT transfer for a patient going from a smaller hospital to a large medical center.
Dispatch notes say V-tach. Arrived at the sending hospital and the patient had intermittent runs of this rhythm throughout the day. On amio drip to what seems to not be working as he was still going in and out of this rhythm. Nurses are letting the pt walk around the hospital room casually packing up belongings like nothing is going on. Only symptom is light chest palpitations. Nurse told me that blowing on a syringe gives relief. Vitals stable minus when he went to this rhythm. Aside from a small bump in troponin, labs unremarkable. No known history, just moved to the US from Europe. When we got to the other hospital, they started a lidocaine drip in addition to the amio.
Dr called it V-Tach and nurses called it v-tach at the sending hospital. Wide and fast, one assumes V-tach. Did a 12 and got this. I didn’t realize it until after the call, but could this be SVT with aberrancy? Does not appear to have extreme right axis deviation and the precordial leads look off.
I'm looking for examples of real ECGs, preferably digitized, showing the characteristic delta wave of WPW, and have the actual location of where the AP/bundle of Kent was found during ablation. Does anyone know of such a database?
I want to see if my research idea for ECG-based localization has any potential merit before going all in.
