McGill Case 87: Difference between revisions

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[[File:E0007871.jpg|thumb|600px|left|These are two strips from a 90 year old patient with a pacemaker.  
[[File:E000789.jpg|thumb|600px|left|This is an electrocardiogram from an elderly woman with palpitations.
The pacemaker was past end of life and one paced beat can be seen in the top strip. Note the pacemaker was not sensing at this time. The patient's rhythm is complete heart block (note the slight variation in the pr interval which supports this interpretation)
The cardiogram shows a wide complex tachycardia with a left bundle branch morphology at a rate of about 160/min. The R wave in V2 is broad and the time from the beginning of the QRS in V2 to the peak of the S wave is longer than 80 ms. No P wave activity is clearly seen. The cardiogram suggests ventricular tachycardia. The patient has done well since this cardiogram on flecainide and metoprolol.]]
 
The Second strip shows Torsade de Pointe ventricular tachycardia, note the long QT interval >600ms., the polymorphic morphology and the late coupled PVC the induces the run.  
 
Replacement of the pacemaker terminated the arrhythmia.]]
 
[[File:E0007872.jpg|thumb|600px|left|]]

Latest revision as of 04:45, 15 February 2012

This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia.


Previous Case: McGill Case 86 | Next Case: McGill Case 88

This is an electrocardiogram from an elderly woman with palpitations. The cardiogram shows a wide complex tachycardia with a left bundle branch morphology at a rate of about 160/min. The R wave in V2 is broad and the time from the beginning of the QRS in V2 to the peak of the S wave is longer than 80 ms. No P wave activity is clearly seen. The cardiogram suggests ventricular tachycardia. The patient has done well since this cardiogram on flecainide and metoprolol.
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