ECG quiz #3 + answer

Re: ECG quiz #3

S-J — Wed, 19 Feb 2014 21:00:36 GMT

thanks mike, really enjoying these, iv always struggled with ecgs and being confident in my answers but these are really helping

Re: ECG quiz #3

Mike Martin — Wed, 19 Feb 2014 09:41:36 GMT

Thanks for participating. Sorry for the slow posting of the 'answer' - had a busy spell with courses elsewhere.

3 seconds are indicated by the horizontal line. 7 beats in 3 seconds = 140 per minute. Or, 10 beats in 4 seconds = 150/min.

The 'exam' answer: There is an underlying sinus rhythm at 140 to 150/min with a supraventricular premature complex (SVPC).

This is an SVPC because it is very similar to the normal QRS in this dog, ie. narrow and positive (as opposed to being very different as seen in the previous case with the VPC). It is slightly smaller in amplitude, which is just 'one of those variants'.

The arrow points to - what looks like a hidden 'ectopic P wave'. So this SVPC could be further classified as an Atrial premature complex (APC).

Arrhythmias really need at least 24 hour Holter monitoring to fully evaluate - if they are suspected to be important. Simple APCs like this can be 'adrenaline' induced in a nervous dog 'in the vets'. Often they can be secondary to atrial disease, such as atrial dilation. In this dog, it had a history of episodic weakness associated with a sustained SVT, which we found on Holter. It was the history that prompted the use the Holter in this instance.

Re: ECG quiz #3

Catherine Goulding — Wed, 29 Jan 2014 18:39:18 GMT

premature junctional contraction???

Re: ECG quiz #3

Nick Shackleton — Wed, 29 Jan 2014 18:10:51 GMT

I was thinking it might be SA node block. Can't be VPC as complexes are usually wide and bizarre

Re: ECG quiz #3

Susan Jackson — Tue, 28 Jan 2014 22:00:59 GMT

Ok theres a normal QRST but its early and without a obvious P, sorry Mike can't remember what its called. I'll have to get your book out.

Re: ECG quiz #3

fairy — Mon, 27 Jan 2014 22:57:52 GMT

Okay. An anomaly in relation to respiration. Not sinus arrhythmia but a missing factor in the normal Pqrs complex rhythm in relation to breathing. Bring on the thicky points.

Re: ECG quiz #3

Fuzzyduck — Mon, 27 Jan 2014 22:31:02 GMT

I just guess, even if I'm being thick! I think there is a supraventricular premature complex, missing a P wave and close to the previous complex after the first 6 sinus beats.

Re: ECG quiz #3

fairy — Mon, 27 Jan 2014 21:47:06 GMT

I don't know if this resonates with anyone else, but I am scared to answer in case it is completely wrong.... I love the idea, just worried about being thick!