Case 102: A 61-Year-Old Woman in the Cardiac Surgical ICU
History
Diagnosis
ECG 2
ECG 2 Diagnosis
ECG 3
ECG 3 Diagnosis
History
A 62-year-old woman is in the cardiac ICU following aortic valve replacement because of aortic stenosis:
Diagnosis
- AV Dissociation
- Marked sinus bradycardia with sinus arrhythmia and a ventricular escape rhythm, 43/min.
- One AV capture, one fusion complex
ECG 2
This ECG is recorded 7 1/2 hours after ECG 1. The patient is stable and in satisfactory conditions:
ECG 2 Diagnosis
- Marked sinus bradycardia (44/min) with sinus arrhythmia
- Ventricular escape rhythm. As the sinus rate varies (probably with breathing), ventricular complexes, fusion complexes and AV capture alternate.
- The AV capture complexes show ST depression, consider inferior and anterolateral ischemia
ECG 3
This ECG is recorded 13 hors after ECG 2. The patient remains clinically stable:
ECG 3 Diagnosis
- Compared with the previous tracing, the heart rate has increased
- Sinus bradycardia, 56/min.
- ST and T wave abnormality, consider anterolateral ischemia
- Ventricular complexes are no longer present
ECG ID: E534