Pages

Friday, June 30, 2017

A 60 year old woman with a h/o Rheumatic heart disease and recently being treated for heart failure...


This ECG was recorded from a 60-year-old woman with rheumatic heart disease. She had been in heart failure, but this had been treated and she was no longer breathless.

What does the ECG show and what question might you ask her?

The ECG shows:
• Atrial fibrillation with a ventricular rate of 60-65/min
• Normal axis
• Normal QRS complexes
• Prominent U wave in lead V2
• Downward-sloping ST segments, best seen in leads V5-V6

Clinical interpretation
The downward-sloping ST segments (the 'reverse tick') indicate that digoxin has been given. The
ventricular rate seems well-controlled. The prominent U waves in lead V2 could indicate hypokalaemia.


Diagnosis
Atriat fibrillation with digoxin effect

What to do
Ask the patient about her appetite: the earliest symptom of digoxin toxicity is appetite loss, followed by nausea and vomiting. If the patient is being treated with diuretics, check the serum potassium level - a low potassium level potentiates the effects of digoxin. If in doubt, the serum digoxin level is easily measured.

2 comments:

  1. Good day to all viewer online am so happy sharing this great testimony on how i was checking for solution in the internet then miraculously i came Across Dr.Aire the powerful herbalist that Cure Numerous individuals Herpes Simplex Virus,so I contacted him base on the testimonies I?m seeing about him on the internet, I was cured too by him, kindly contact him actoday through his email he can help you email ; drairehome@gmail.com OR WHATSAPP +2347036740271

    ReplyDelete
  2. I started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their website at www.ultimatelifeclinic.com I can breath much better and It feels comfortable!

    ReplyDelete