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See these publications for more information Overall, management for cardiac contusion is mostly supportive unless surgical complications develop, involving appropriate treatment of dysrhythmias and hemodynamic instability. Circulation: Cardiovascular Imaging. 2015, March 1). Myocardial contusion in an 8-year-old boy. Cramer, M.
There were no dysrhythmias on cardiac monitor during observation. This discussion comes from this previous post: Hyperthermia and ST Elevation Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias. Circulation, 117, 1890–1893. [3]:
I also believe that we physicians and medics are eager to treat dysrhythmias, and we want to see them even when they are not there. Circulation 2008;117(14):1897-907. Dilated pupils and hypertension are a strong clue to sympathetic overload, but don't forget anticholinergic syndromes, including tricyclics! Pollan S, Tadjziechy M.
Similarly, there have been case reports of patients who were taking beta blockers to control dangerous heart rhythm disturbances and when the beta blocker was abruptly stopped it led to precipitation of ventricular dysrhythmias and even in some cases death. This is termed as ‘Acute beta blocker withdrawal syndrome’.
So the real QT is shorter, but the computer does not mention the U-wave, and the U-wave is as important as the T-wave in predicting cardiac dysrhythmias. mEq of K pushed fast and circulated theoretically would raise serum K immediately by 1.0 This is an extremely dangerous ECG. The K returned at 1.9 This is extremely low for DKA.
Could the dysrhythmias have been prevented? mEq of K pushed fast and circulated theoretically would raise serum K immediately by 1.0 Severe hypokalemia in the setting of STEMI or dysrhythmias is life-threatening and needs very rapid treatment. Since it takes some time (how long?) mEq/L, and 10 mEq would increase it by 3.3
Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. Circulation. Circulation, 137(19), p.e523. (For those of you who are accustomed to the units of high sensitivity troponin (ng/L), this is equivalent to 20,956.00 Again, cath lab was not activated. 112.105718.
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.
mEq of K pushed fast and circulated theoretically would raise serum K immediately by 1.0 I could find very little literature on the treatment of severe life-threatening hypokalemia. There is particularly little on how to treat when the K is less than 2, and/or in the presence of acute MI. Since it takes some time (how long?) mEq/L, from 1.9
Smith comment: In a large randomized trial of dopamine vs. norepinephrine (11) for shock which was published after the above-mentioned recommendations, dopamine had more adverse events (especially severe dysrhythmias, and especially atrial fibrillation). Circulation. Circulation 67, No. Circulation 1970;41:623-627 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. E CG # 2 in Figure-1 shows a moderately long RP’ interval.
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