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But adenosine only lasts for seconds, and if the dysrhythmia recurs, then the adenosine is gone. Prevent the initiation of the dysrhythmia -- this can be done with a beta blocker by prenenting PACS 2. Patients should be offered a choice for a trial of medication vs ablation for this non-life-threatening arrhythmia.
Atrial dysrhythmias, and atrial fi brillation in particular, are frequently misdiagnosed by computer algorithms and then by the physician who overreads them. of all cases, and 62% of Veritas® misdiagnoses). == MY Comment , by K EN G RAUER, MD ( 1/5/2020 ): == This case illustrates a number of important teaching points. GET a 12-lead!
Inferior MI results in scar tissue which is a likely source of a re-entrant ventricular dysrhythmia. There are 6 KEY parameters to consider in systematic assessment of any arrhythmia. IF interested in more on the topic of fragmentation — See My Comment in the January 31, 2020 post. This would be the likely source of the VT.
Physicians initially attributed symptoms to “panic, anxiety or stress” in half of these patients, with women more likely than men to have their symptoms attributed to psychiatric causes (65% vs. 32%; P < 04). == MY Comment by K EN G RAUER, MD ( 9/7/2020 ): == Interesting case with thorough discussion by Dr. Smith on arrhythmia management.
The limb lead abnormalities appear to be part of the Brugada pattern, as described in this article: Inferior and Lateral Electrocardiographic RepolarizationAbnormalities in Brugada Syndrome Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias. There was a 0.9%
Here is one full text article on the topic from Clinical Cardiology 2008: Diagnostic Approach and Treatment Strategy in Tachycardia-induced Cardiomyopathy Atrial Tachycardia (AT): another SVT in the ED Rapid dysrhythmia from non-sinus focus above AV node. This is a “ generic ” term. Our THANKS to Dr. Smith for presenting this case!
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