Tag Archives: SVT

The Trouble with Sinus Tachycardia

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  Sometimes recognizing sinus tachycardia can give us fits. What? Sinus tachycardia? One of the most basic rhythms? The discussion that follows will highlight some of the difficulties sinus tach can present at high rates. The pitfalls of using the generalized term "SVT" will also be discussed. This discussion is not meant to imply that […]

Snapshot Discussion: 32 year old Male–Chest Discomfort

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Here is the discussion for the Snapshot Case: 32 year old male–Chest Discomfort. Sorry for the delay. If you recall, we have a young patient, a 32 year old male, with a heart rate too rapid to count. He is alert and oriented, and has a good pressure (126/70). He has been in the following […]

Narrow complex tachycardias – Part III

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Documenting the heart’s response to adenosine Let’s look at some different cases where adenosine was used. Rather than give you all the details about the age, gender, chief complaint, and vital signs, I’m just going to show you the rhythm strips. Right now I’m only concerned with how the heart behaves during the administration adenosine. […]

Narrow complex tachycardias – Part II

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Here’s a call that was very well executed. The patient was a 35 year old Hispanic female; walk-in patient at a volunteer clinic. Through an interpreter it was learned that the patient was complaining of palpitations and slight chest discomfort. The onset was sudden. The medical history was significant for “arrhythmias”. No medications. Skin: warm […]

Narrow complex tachycardias – Part I

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I've come to dislike the term "SVT" (supraventricular tachycardia). In the first place, it's not an arrhythmia. It's an umbrella term that covers a group of arrhythmias which require the AV node for their maintenance. Most importantly, it includes sinus tachycardia! For some reason, this is a difficult concept for many clinicians to grasp, partly […]

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Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Olivier
Snapshot Case: What Happened?
To support Donovan's analysis, QRS are remarkably thin and eventually consistent with paediatric findings. However, as noted, atrial fibrillation in very young patients are quite rare.
2015-05-28 07:36:54
Donovan
Snapshot Case: What Happened?
Looking back on the dosages, though, it occurs to me: this may be a pediatric patient. If that is the case, then for 50 J to be an appropriate dose for Shock 4 (again, assuming the patient is unstable), they would have to weight 25 kg. If that is the case, then the accidental induction…
2015-05-28 01:46:30
Donovan
Snapshot Case: What Happened?
1) Why convert the first rhythm? (brought up by a couple of commenters) -- As is posted in the initial: "required emergent cardioversion for unstable rapid atrial fibrillation" ... rate is not the determining factor about stability, the presence or absence of signs of shock are (hypotension, acutely altered mental status, ischemic chest pain, usw).…
2015-05-28 01:27:57
Ruud Valkenborg
Snapshot Case: What Happened?
Beautyfull R on T with a unsynchronised ECV. :-)
2015-05-27 07:38:19
george
Snapshot Case: What Happened?
why cardiovert urgently in this case? The first strip shows a "well controlled" heart rate. Cardioversion provoked torsade de points due to unsync administration....... Unnecessary risk taken......when amiodarone or flecainide would do the job "quietly".....
2015-05-27 06:46:53

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