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.
• 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.
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