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Post by pbruss on Dec 11, 2014 4:25:53 GMT -5
47 yo male with cardiac arrest. intubated, pulse came back with EMS. went to cath lab. Tracked down an old EKG which is attached. What is your interp and diagnosis? Attachments:
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Post by tyson on Dec 11, 2014 14:23:05 GMT -5
looks like J wave, moreso than epsilon wave. hard time calling it hypothermia if this was on old EKG. can have bleeds and electrolyte abnormalities that present w/ J waves. ekg shows anterolateral st depression. mild AVR st elevation.
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Post by Bjs04f on Dec 12, 2014 5:50:25 GMT -5
Nice tyson dropping the epsilon wave bomb. What was his arrest rhythm, just curious
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Post by pbruss on Dec 13, 2014 0:17:50 GMT -5
i do think that this EKG fits the criteria for ARVD. that does look like an epsilon wave to me. I left the computer intervals on there for you and there is a conduction delay. there is also some t wave abnormalities in the precordial leads indicative of a conduction delay. his arrest rhythm was V fib. if any thing it may have been useful to fax that EKG to an EP doc during his visit to the ER at that time. don't know if it would of changed the outcome at all. attached a recent paper about diagnosing ARVD from an EKG. enjoy. |
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Post by kemple on Dec 14, 2014 12:39:52 GMT -5
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Post by Bjs04f on Dec 14, 2014 12:45:46 GMT -5
keeweedoc is an awesome name, but damn those epsilons are subtle in the ekg, V2-3 have some. Looking at above I think its tough, theres V2 which looks epsilonish, but throughout the rest kinda osbourny
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