Remove Chest Pain Remove Dysrhythmia Remove Echocardiogram
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WHAT EXACTLY IS AN ARRHYTHMIA?

Dr. Sanjay Gupta

In that sense, the term dysrhythmia is preferable because it does literally translate as a disturbance in normal rhythm which is exactly what it is meant to describe. Any unsolicited disturbance of the rate or rhythm can be termed a dysrhythmia and result in the heart beating less efficiently but only for the duration of the dysrhythmia.

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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

He denied chest pain or shortness of breath. In the clinical context of weakness and fever, without chest pain or shortness of breath, the likelihood of Brugada pattern is obviously much higher. Formal echocardiogram showed normal EF, no wall motion abnormalities, no pericardial effusion. Is there fever again?

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A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

Hopefully a repeat echocardiogram will be performed outpatient. ECG of pneumopericardium and probable myocardial contusion shows typical pericarditis Male in 30's, 2 days after Motor Vehicle Collsion, complains of Chest Pain and Dyspnea Head On Motor Vehicle Collision. 1900: RBBB and LAFB are almost fully resolved.

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Back to basics: what is this rhythm? What are your options for treating this patient?

Dr. Smith's ECG Blog

She reports that she is now unable to vagal out of her palpitations and is having shortness of breath and dull chest pain. 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.

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An athletic 30-something woman with acute substernal chest pressure

Dr. Smith's ECG Blog

Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. These are reperfusion T-waves (the same thing as Wellens' waves) Echocardiogram Regional wall motion abnormality-distal septum and apex. Again, cath lab was not activated. What does this troponin level mean?

SCAD 52
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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

A formal echocardiogram was completed the next day and again showed a normal ejection fraction without any focal wall motion abnormalities to suggest CAD. It was from a patient with chest pain: Note the obvious Brugada pattern. The Troponin I was cycled over time and was 0.353 followed by 0.296. This patient ruled out for MI.

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60-something with wide complex tachycardia: from where does the rhythm originate?

Dr. Smith's ECG Blog

Inferior MI results in scar tissue which is a likely source of a re-entrant ventricular dysrhythmia. Echocardiogram: Estimated left ventricular ejection fraction, lower limits of normal; 45-50%. Here is the post-cardioversion ECG: There is sinus with RBBB There are inferior Q-waves suggesting old inferior MI.