The Tachycardias | The Advanced EM Boot Camp (ECG Workshop) - Preeti Jois, MD

[@drsal6099]

The ECG at 22:36 is not just AF.. It's AF with WPW (or some other accessory pathway).. ECG features 1) Irregularly irregular rhythm with rate >200 2) QRS with varying width & morphologies AF with fast ventricular rate can't go beyond a rate of around 200, bcz of the decremental conduction property of the AV node. So if the rate of AF goes beyond 200, there must be an accessory pathway connecting the atria to the ventricles (such as WPW) Clinical significance of AF with WPW: Av nodal blockers like Adenosine, BB, CCB, Digoxin & Amiodarone is contraindicated. Bcz if you administer any of these drugs, it would block the AV node & all the 350-600 atrial impulses formed in AF would travel down the accessory pathway, thereby converting AF to VF ..

[@alexhaile5516]

That was a 10 second strip. For irregularly irregular rhythm, you determine the rate by multiplying the number of R waves on the rhythm strip by 6. 6 times 23 = 138. the QRS are narrow, definitely below 120ms. There are diffuse ST depressions (both downsloping and horizontal) some of which are above 1mm. This indicates A-fib with diffuse ischemia which suggests an unstable A-fib. The patient needs electrical synchronized cardioversion.

[@nataliasoto0425]

Thank you for the class, I learned a lot!! You made things look more simple!!

[@louisvarre2197]

Love the addition of doubling the paper speed! It’s great to have extra tools in your tool box to help you make a diagnosis.

[@glorychukwuma3264]

You made reading these ECGs easy. Thank you

[@MrJeweledfez]

Good lecture. Are you sure the EKG at the end of your bradycardia video is a complete heart block? It looks like a Mobitz type two second°.

[@sanketmali8038]

Nice lecture

[@jasmanbirsingh9037]

Good presentation....thanks

[@MrFritzenMatheus]

Great lesson. Thank you so much.

[@drgadham]

Good teaching

[@anitablanco7309]

Are there any types of atrial flutter except the sawtooth?

[@drdannegoita]

When you see a regular heart rate at about 150/min you should suspect Atrial flutter (with 2:1 block). The flutter waves can have a more rounded shape but are nonetheless about 300/min (aproximately one flutter wave per big box). I don't remember whether I ever saw that in my own practice, but I saw that on Medscape's "ECG of the week" section. Go there and enjoy some interesting ECG ;)

[@anitablanco7309]

@@drdannegoita Thanks! I'm a monitor tech but we do a basic interpretation only. I saw a lot of heart rhythms and hard to interpret. I wish I could email you the paper.

[@drdannegoita]

I love ECG. Mail me the ECGs. I'll see if I can help you. ddnegoita @ live . com

[@anitablanco7309]

@@drdannegoita I will and thank you so much!

[@Andrew-im7fg]

Oh she’s hilarious!

[@fayedk73]

Really loved the video 😍

[@dom38701]

she is so lovely to watch

[@GarmrK9]

Nice lecture but I would not want her to be my colleague 😬 😳

[@DH-vy8hw]

I see what you mean;)

[@breemorrison901]

Is this speaker a psychopath or something? Her disdain for her patients is pretty off-putting. 😮