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cardio

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15 Posts

hero
Forum Guru

Topics: 41
Posts: 539

07/02/08 - 10:27 AM

32. A 34 yo man comes to ED with palpitations. The ECG is alternating btw narrow complex tachycardia and wide complex tachy. The narrow complex tachy is associated with a PR interval of 0,08 sec
The most appropriate medical Tx is

digoxin
procainamide
diltiazem
metoprolol
adenosine

Eagle_303
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Topics: 77
Posts: 659

07/02/08 - 11:26 AM

Very strange type of tachycardia.
Are you talking about accelrated idioventricular tachycardia with capture beats ??

mikky
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Topics: 17
Posts: 459

07/02/08 - 11:48 AM

well..isn`t this pulses alterans seen in pericardial effusion??? confused

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Eagle_303
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07/02/08 - 11:54 AM

mikky wrote:
well..isn`t this pulses alterans seen in pericardial effusion??? confused

In pericardiac effusion ,you see electrical altenance not pulsus alternans

kpmle2
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Topics: 81
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07/02/08 - 12:02 PM

adenosine

hero
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Topics: 41
Posts: 539

07/02/08 - 12:27 PM

PR interval of 0,08 sec

Eagle_303
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Topics: 77
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07/02/08 - 12:44 PM

Hero ! please what is the nature of this tachycardia ? Please guide us.
Thanks

hero
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Topics: 41
Posts: 539

07/02/08 - 01:09 PM

lower limit of normal PR interval is 0,12 sec

concept is always escaping from my attention, i'm actually trying to help myself smiling face

Eagle_303
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Topics: 77
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07/02/08 - 02:49 PM

hero wrote:
lower limit of normal PR interval is 0,12 sec

concept is always escaping from my attention, i'm actually trying to help myself smiling face

Please disclose the diagnosis ??
We will appreciate your effort.Thanks

hero
Forum Guru

Topics: 41
Posts: 539

07/02/08 - 04:22 PM

#10

(B) procainamide
when a pt has alternating narrow and wide complex tachy you should suspect a pre-excitation syndrome (WPW). In addition, PR interval is abnormally short.

PRe-excitation - short PR interval - PRocainamide

liliaeliz
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Topics: 41
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07/02/08 - 04:53 PM

#11

procainamide ,accesory pathway?

Eagle_303
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Topics: 77
Posts: 659

07/02/08 - 07:19 PM

#12

At one setting it can never (according to my humble knowledge) happen in WPW syndrome that it is alternating, A few beats wide complex and a few beats narrow complex.Things would have been different if you have said once the patient comes with narrow complex (Orthodromic ) and next time comes with broad complex (Antidromic). But this term "alternating" is absolutely confusing.
Reference please.I will appreciate.

hero
Forum Guru

Topics: 41
Posts: 539

07/02/08 - 08:50 PM

#13

fischer's internal medicine q book section 5 q 32

sorry for confusing you, me confused as well

mikky
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07/03/08 - 11:43 AM

#14

so electrical alternans is pericardial effusion and orthodromic at one time and antidromic at another time is WPW....thanx hero and eagle for teaching me grin

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liliaeliz
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07/03/08 - 11:57 AM

#15

hero it is WPW +AF ?

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