A 35 yr old male who presents with palpitations, dysponea, and light-headedness for the preceeding hour. He has normal vital signs and this ECG.
A 35 yr old male who presents with palpitations, dysponea, and light-headedness for the preceeding hour. He has normal vital signs and this ECG.
Rapid irregular rhythm with some very rapid sections with subtle QRS morphological differences.
Strongly suggests WPW with AFib.
Since stable (now). IV. Put defib pads on and assure good sync. Start procainamide. Be prepared to sedate and cardiovert at first sign of de compensation.
DO NOT GIVE A-B-CD
Adenosine, amiodarone
Beta blockers
Calcium blockers
Digitalis
thanks for the great comments Andrew. Sorry I didn’t get back to you sooner but lost your comment initially in a pool of spam.
Agree with all your comments. Procainamide is generally not available in Australia so cardioversion would generally be preferred here.
For ECG of the Week, because we have kept it on a different site, it is best to make comments there and be part of the discussion
http://jhcedecg.blogspot.com.au