Name the Rhythm II

[mikeylikesit]

Ok the last name the rhythm was not very good I know. Here is another one of a bit better quality. Enjoy and good luck!

 

[Hastings]

That's the one where the dude has the little thingy that goes ZAP ZAP ZAP to the heart.

 

[mikeylikesit]

That's the one where the dude has the little thingy that goes ZAP ZAP ZAP to the heart.

LOL Pacemaker...i know you knew that. No there is no pacemaker on this patient even though it is easy to confuse with the spikes before the QRS complex.

 

[fma08]

A-Fib with an aberrant conduction?

 

[MSDeltaFlt]

A-Fib with an aberrant conduction?

That's assuming that the lead shown is Lead II, and it is completely indicative of the 12 Lead.

 

[mikeylikesit]

A-Fib with an aberrant conduction?

I can see how you deduce a fib based on the wandering QRS complexes but there is something noticeable each time before the QRS complex begins.

 

[daedalus]

A Fib with ST depression.

 

[mikeylikesit]

still no atrial fibrillation, notice what is coming before each QRS complex and what is happening afterward with the T waves. since there is a consistency this EKG is a little harder to depict than most. Notice the rate elevation toward the end.

 

[fma08]

if you are saying there's p-waves there, i can see how there would be before the first QRS, and it may just be me but i'm not seeing anything that would resemble a difinitive p-wave before any of the following QRS complexes. and t-waves are inverted... soo... ischemia?

 

[fma08]

and the first question i should have asked was is there a pulse on this patient?

 

[MedicPatrick]

You really need to stop putting the rhythm name in the image URL.

 

[mikeylikesit]

You really need to stop putting the rhythm name in the image URL.

Yes fma the patient has a pulse, and as far as the link in the pic i forgot this time fortunately this rhythm had to be cropped off a sheet of 4 rhythms so there is no way to determine if the actual rhythm is on there. look how closely the "pr" interval(non existant), what does this tell you that it is?

 

[fma08]

junctional then... since it's not a 6 second strip i'm gonna say that it's probably in the tachy range and its irregular so there's either a block goin on or pjc's

 

[mikeylikesit]

junctional then... since it's not a 6 second strip i'm gonna say that it's probably in the tachy range and its irregular so there's either a block goin on or pjc's

Bingo, also known as junctional tachycardia with an exit block...and i did just realize that my pics had the answer in the line.