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In a world where technology reigns supreme, one of the most profound tools in medicine remains the irreplaceable electrocardiogram (ECG). The electrical impulse goes further to the atrioventricular (AV) node, whose role is to slow down the conduction from the atria to the ventricles long enough for atrial contraction to occur.
The sinus node, when not interrupted, occurs more than 600 ms after the previous atrial beat, so sinus tachycardia is NOT present __ One might call this multifocal atrial tachycardia (MAT) , but since there are definite sinus beats which are not tachycardic, this is sinus with multifocal atrial premature beats. Poon et al.
Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. LAFB, atrialflutter, anterolateral STEMI(+) OMI. Sent by Pete McKenna M.D. Triage ECG: What do you think?
Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. Family history of sudden death at age less than 40 Negative predictors : pacemaker, pre- or near- syncope only Workup (Smith opinion from literature) Always evaluate with: 1.
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