wide qrs tachycardia rea… · rbbb pattern • qr, rs or rrl in vi frontal plane axis range from...
TRANSCRIPT
Wide QRS tachycardia
Cardiology Fellow ��������:����
Normal sinus rhythm• Originate from sinus node• All same P wave• P followed by narrow QRS (<120ms)
RSR’ pattern in V1 Deep slurred S waves in V4-V6
Dominant S wave+ broad notched R in V1 waves Absent Q waves in V4-V6
RBBB LBBB
Aberrant conduction 1.Bundle branch block (RBBB or LBBB) 2.Hyperkalaemia 3.Poisoning with sodium-channel blocking agents (e.g. Tricyclic antidepressants) 4.Pre-excitation (i.e. Wolff-Parkinson-White syndrome) 5.Ventricular pacing 6.Hypothermia
EKG case
VAGAL MANEUVER TECHNIQUESto slow a person’s heart rate
• Valsalva maneuver: increase intrathoracic pressure and stimulate the vagus nerve
• Coughing • Cold Stimulus face• Gagging• Carotid Massage: Pressure is applied underneath the angle of the jaw in a gentle circular motion for ~10 secs