Patient loses consciousness and pulse during EKG registration

What is your diagnosis and the best treatment?

In this ECG Case we can't identify any P waves, QRS complexes or T waves. All what we can see is chaotic irregular ventricular deflections of varying amplitude and frequency >400/min. This findings are features of Ventricular fibrillation
• Ventricular fibrillation can be coarse and fine. Coarse ventricular fibrillation occurs earlier after the onset of cardiac arrest and has high amplitude fibrillatory waves. In opposite, fine ventricular fibrillation occurs more later, is less organized with lower amplitude fibrilatory waves.
• Coarse ventricular fibrillation frequently looks like TDP or Non-TDP polimorphyc VT.
• Previus ECG of this patient did not have a long QT. This fact is against TDP.
 In conclusion patient was hemodynamically unstable so in this moment it is not important to differentiate Coarse VFib from TDP. Gave unsynchronized cardioversion (Defibrillation) to the patient.

Comments

Post a Comment

Popular posts from this blog

Sinus tachycardia vs Sinus bradycardia vs Sinus arrhythmia

Image
A) Sinus tachycardia is sinus rhythm with heart rate over 100/min. This rhythm is regular with normal appearance P wave and normal duration PR intervals. QRS complexes can be narrow or wide. B) Sinus bradycardia is sinus rhythm with heart rate bellow 60/min. This rhythm is regular with normal appearance P wave and normal duration PR intervals. QRS complexes can be narrow or wide. C) Sinus arrhythmia is sinus rhythm with variation of P-P (R-R) intervals at least 120ms. P wave has normal appearance and normal PR intervals. QRS complexes can be narrow or wide.
Read more

First degree vs Second degree vs Third degree AV Block

Image
Name this Blocks A. First degree AVB is present in this rhythm strip. Every P wave is conducted, but with prolonged PR interval (~320ms). B. Second degree AVB type 1 (Mobitz I) is present in this rhythm strip. We can see progressive prolongation of the PR interval culminating in a non-conducted P wave (3d and 7d P wave are non-conducted). C. Second degree AVB type 2:1 is present in this rhythm strip. We can see that there are 2P waves for every QRS complex. We don’t have two P wave conducted in a row so can’t conclude if PR interval is prolonged (Mobitz I) or constant (Mobitz II). D. High degree AVB (3:1) is present in this rhythm strip. We can see that just every 3d P wave is conducted (with constant PR interval) and two out of every three P wave are blocked. E. High degree AVB (4:1) is present in this rhythm strip. We can see that just every 4d P wave is conducted (with constant PR interval) and three out of every four wave are blocked. F. Third degree AVB is present i
Read more

RBBB vs LBBB vs IVCD

Image
This ECG shows: a) RBBB b) LBBB c) IVCD This ECG present typical changes for RBBB. The RBBB criteria fulfilled in this case are: -           Supraventricular rhythm. -           Wide QRS complex (>120 ms) with rsR’ morphology. -           Slurred S wave in V6. -           T wave discordance in precordial leads.   The most common cause of RBBB are: ASD, COPD, right ventricular hypertrophy, pulmonary thromboemboli, ischaemic heart disease, hypertension, cardiomyopathy.
Read more