CARDIAC BOOTCAMP
  • HOME
  • Course Login
    • Log In
    • Log Out
  • SYLLABUS
  • STORE
    • Online Self Study Course
    • Cardiac Video Course
  • ECG OF THE WEEK

ECG OF THE WEEK

BECOME A COURSE MEMBER
Each Week we put up one ECG case for you....because it's easier to learn from cases.
The ECG of the week is FREE to everyone. To become an expert at ECG's join the Cardiac Bootcamp Course. It's a great way to Learn!
​Or come to one of our LIVE Cardiac Bootcamps

a 48 yo male with palpitations

14/12/2021

0 Comments

 
A 48 yo male presents to the emergency department with a complaint of a rapid heart rate. He has been known to be in this before and is usually on Sotalol, but has not taken any for two days. He has also been drinking heavily the night before. He states that at 7.15 that morning he felt his heart start to race suddenly. His ECG is shown below. What is your diagnosis?
Picture
This ECG shows an atrial tachycardia with atrial rate of 120bpm. The p waves are inverted in III and aVF, which is abnormal. This is a unifocal atrial tachycardia. It can occur in structurally normal and abnormal hearts. it arises from a particular part of the atrium and its location can be diagnosed by the axis of the p waves.
Below is another example:
Picture
This is someone at a rate of 120bpm. Notice the inverted p’s in lead III. Again, this is unifocal atrial tachycardia.
Clinical Presentation
The usual presentation is one of palpitations, but may be that of syncope, or cardiac failure if the patient has been in the rhythm long enough.
Workup
An ECG and electrolytes to ensure no abnormalities and a full blood count to exclude anaemia.
Very few other investigations are needed in the emergency department. Perhaps a chest xray if lung pathology is suspected. The patient should have an echocardiogram, to look for structural abnormalities, but this can be as an outpatient.
Management
The unifocal atrial tachycardia can be treated like an SVT.
The general treatment for this condition is:
  1. Pharmacological
    1. Beta blockers
    2. Calcium channel blockers
  2. Cardioversion
In this case we gave the patient his usual dose of Sotalol and waited, however it was clear that there was not going to be resolution, so we proceeded to cardiovert.

0 Comments



Leave a Reply.

    Author

    Dr Peter Kas
    ​Emergency Physician

    Picture
    Sign up for
    ECG of the week
     Its free

    Archives

    December 2022
    November 2022
    October 2022
    September 2022
    August 2022
    July 2022
    June 2022
    March 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    September 2020
    August 2020
    July 2020

    Categories

    All
    Atrial Fibrillation
    Atrial Flutter
    Atrial Tachycardia
    Axis
    Bradycardia
    Cardiac Arrest
    Chest Pain
    ECG Mimics
    Ischaemia
    Lead Reversal
    Pacing
    Paediatric ECG
    Paediatric Syncope
    Pericarditis
    QT Interval
    STEMI
    STEMI Mimics
    SVT
    Ventricular Tachycardia
    Wellens
    Wide Complex Tachycardia

Our Other Websites to Visit

www.emcore.com.au
www.resus.com.au

Contact Us
© COPYRIGHT 2015. ALL RIGHTS RESERVED.
  • HOME
  • Course Login
    • Log In
    • Log Out
  • SYLLABUS
  • STORE
    • Online Self Study Course
    • Cardiac Video Course
  • ECG OF THE WEEK