12 Lead ECG Interpretation Course by Dr. Vernon Stanley Course Overview
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FREE 12-Lead ECG Interpretation Tracing of the Week
Tracing #22    [ Scroll down to submit answer ]
You are working as a paramedic and are asked to evaluate a 42-year-old female with complaints of seizure activity. Her 12-lead is as shown below and your differential diagnosis would be as follows: ... (choose only one)
Tracing of the Week (Tracing #22)
A..... Hypokalemia.
B..... The patient is at risk for polymorphic ventricular tachycardia (Torsades de Pointes).
C..... P-wave height suggestive of right atrial enlargement.
D..... Diffuse ST depression and biphasic T-waves consistent with ischemia. However, these changes are non-specific and might be simply secondary to the prolonged QT pattern.
E..... Hypomagnesemia.
F..... If the patient has recurrent syncopal episodes and a sibling died of sudden cardiac death at age 36 years, treatment mode possibilities should include a beta blocker and an automatic implantable defibrillator.
G..... History of seizure disorder with negative work-up. Patient might be experiencing transient episodes of ventricular tachycardia (Torsades) as a result of QT prolongation.
H..... Bazett's Equation reveals a QTc in excess of 500 msec. This represents QT prolongation and the patient is at risk for Torsades de Pointes.
I..... QT prolongation consistent with tricyclic overdose. The patient is at risk for sudden death.
J..... All of the above..........See pg 44 and 80 of Dr. Stanley's FIELD GUIDE TO RHYTHM INTERPRETATION for discussion of QT/QTc interval and Bazett's Equation.Available thru bookstore at www.ecgcourse.com.
© 2013 Vernon R. Stanley, M.D., Ph.D. All rights reserved.