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Ekg Case Study Answers

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A 54-years-old man presents to the cardiology unit for the evaluation of palpitations he has been feeling for 1 week. He had no significant past medical or surgical history, except for asthma. He is a non-smoker. On examination, he has a blood pressure of 120/80 mmHg and heart rate of 98 beats/minute with an irregularly irregular rhythm, and the rest of the examination was unremarkable. His EKG is shown below:

19) What is your diagnosis?
A) Atrial flutter
B) Atrial fibrillation
C) Ventricular tachycardia
D) 1st degree heart block
E) Sinus bradycardia
Answer: B
Explanation:
(Choice B) The EKG shows: an irregular rhythm (i.e. QRS complexes at an irregular interval), ventricular tachycardia, normally shaped and narrow QRS-complexes, and absent P-waves, which is indicative of atrial fibrillation. Also, the patient has symptoms and signs of Atrial fibrillation, such as: palpitations, tachycardia with an irregularly irregular rhythm. Thus, the patient’s symptoms, clinical and EKG findings are strongly indicative of atrial fibrillation. …show more content…

Ventricular tachycardia (choice C) is characterized by broad QRS complexes, i.e. > 120ms, ventricular rate > 100 beats/min, absence of Left Bundle Branch Block or Right Bundle Branch Block pattern, extreme axis deviation, i.e. QRS positive in aVR and negative in I and aVF, AV dissociation, and capture or fusion

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Atrial Fib: In atrial fibrillation, the atrial rhythm and ventricular rhythms are irregular. The atrial rhythm is greater than 400 beats/minute. The atrial activity looks erratic and irregular. Causes of Atrial fibrillation include COPD, heart failure (which EM has),hyrotoxicosis, constrictive pericarditis, ischemic heart disease, sepsis, pulmonary embolus, rheumatic heart disease, hypertension, mitral stenosis, atrial irritation, or complication of coronary bypass or valve replacement surgery. If a patients condition is stable, treatment includes drug therapy that may commonly include calcium channel blockers, and beta blockers.

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