Case 22: A 61-Year-Old Man with Palpitations
History
Diagnosis
ECG 2
Compare ECG 1 vs ECG 2
History
A 61-year-old man has developed rapid palpitation with dyspnea and weakness while in the recovery room after GU surgery:
Diagnosis
- Supraventricular tachycardia, rate 152/min
- Negative P waves in the inferior leads, positive P waves in aVR and V1 (pseudo-r’)
- The P waves follow immediately the QRS (there is no gap between QRS and P)
- Findings typical of AV Nodal Re-entrant Tachycardia (AVNRT)
ECG 2
The arrhythmia subsided following vagal stimulation. There is now sinus rhythm, 92/min.
Compare ECG 1 vs ECG 2
- In ECG 1 there is a supraventricular tachycardia (AVNRT) with P waves following the QRS complexes very closely (negative P in II, III and aVF, pseudo-R’ in V1)
- In ECG 2 the P waves precede the QRS and are positive in I and aVF (sinus rhythm, 92/min)
ECG ID: E377