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However, the association between chemotherapeutic agents and atrioventricular re-entrant tachycardia (AVRT)/atrioventricular node re-entrant tachycardia (AVNRT) remains poorly understood. Here, we report a patient with new-onset AVRT/AVNRT and lung cancer who underwent chemotherapy.
The patient was known to have cancer. While not quite satisfying criteria for sinus “tachycardia” ( which is a heart rate ≥100/minute ) — the overall heart rate of 90-95/minute adds to our suspicion. The ECG in Figure-1 was obtained from an older woman. She presented with shortness of breath. Why is every-other-beat changing?
On the monitor patient had wide-complex tachycardia. Differential is ventricular tachycardia versus supraventricular tachycardia with aberrancy versus sinus tachycardia with a aberrancy. After the patient was stabilized with supportive care, the heart rate gradually slowed, confirming sinus tachycardia.
There is a substantial worry about cardiovascular diseases in cancer patients. Due to the variability in the pathophysiology of underlying tumors and chemo-radiotherapy regimens, the risk of cardiotoxicity varies.
He mentioned "cancer" and "chest". There is a narrow complex tachycardia at a rate of 130. ECGs: there is a regular narrow complex tachycardia still at a rate of exactly 130, with no P-waves and also no change since the prehospital ECG. The patient arrived alert but cool and clammy. His chest pain was vague. Is is sinus?
A middle-aged patient with lung cancer had presented to clinic complaining of generalized malaise, cough, and chest pain. There is sinus tachycardia. Symptoms other than chest pain (malaise, cough in a cancer patient) 2. Sinus tachycardia, which exaggerates ST segments and implies that there is another pathology.
There is a regular, wide complex, (mostly) monomorphic tachycardia. The differential of wide, regular, monomorphic tachycardia is: VT or SVT with aberrancy, all +/- hyperkalemia (see diagrams below). He had just had his first oncology visit and had aggressive goals of care to treat his newly diagnosed cancer (no DNR/DNI).
An EKG was repeated around midnight: By itself, this ECG is not diagnostic of anything besides sinus tachycardia, and could be called normal (although there is ST segment straightening in the anterior leads, which should always prompt suspicion). The conventional computer algorithm called “ sinus tachycardia, otherwise normal EKG ”.
Written by Bobby Nicholson MD, with edits by Meyers A woman in her 50s with past medical history of heart failure, prior stroke, atrial fibrillation on Eliquis, lung cancer in remission, and CKD, presented to the emergency department for evaluation of cough and shortness of breath. EKG was obtained in triage and read as ventricular bigeminy.
Written by Destiny Folk MD, with edits by Meyers, peer reviewed by Smith and Grauer A woman in her late 20s with a past medical history of cervical cancer status post chemotherapy and radiation therapy presented to the emergency department for shortness of breath, chest tightness, and two episodes of syncope.
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