ECG Guru - Instructor Resources - Sinus arrhythmia https://www.ecgguru.com/ecg/sinus-arrhythmia en SINUS ARRHYTHMIA https://www.ecgguru.com/blog/sinus-arrhythmia <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/sinus-arrhythmia"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Sinusarrhythmia.jpg" width="2900" height="1910" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p><span style="font-size: 10px;">Here we see the EKG of a 15-year-old girl. The rhythm is irregular, with the heart rate fluctuating between approximately 60 and 90 beats per minute. All P waves are identical, and the PR interval is always constant. Therefore, a sinus arrhythmia is present. In this case, it is a respiratory sinus arrhythmia, which is commonly found in younger individuals. The heart rate increases reflexively during inspiration and decreases during exspiration. This physiological sinus arrhythmia is usually no longer present in older individuals.</span></p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/79/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give SINUS ARRHYTHMIA 1/5</option><option value="40">Give SINUS ARRHYTHMIA 2/5</option><option value="60">Give SINUS ARRHYTHMIA 3/5</option><option value="80">Give SINUS ARRHYTHMIA 4/5</option><option value="100" selected="selected">Give SINUS ARRHYTHMIA 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >5</span></span> <span class="total-votes">(<span >1</span> vote)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-IawETvGeD2Ca2MGSqfvKCDq6-hTu3hyELN4oqlwv7dQ" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fsinus-arrhythmia&amp;title=SINUS%20ARRHYTHMIA"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Thu, 10 Aug 2023 07:07:34 +0000 Dr A Röschl 864 at https://www.ecgguru.com https://www.ecgguru.com/blog/sinus-arrhythmia#comments ECG OF A 3 YO BOY, IS IT NORMAL? https://www.ecgguru.com/blog/ecg-3-yo-boy-it-normal <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/ecg-3-yo-boy-it-normal"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/juvenile.jpeg" width="2871" height="1783" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>Here is the ECG of a 3-year-old boy. Is there cause for concern? The ECG shows a sinus rhythm with significant sinus arrhythmia. The heart rate increases with inspiration and decreases with expiration, which is called respiratory sinus arrhythmia. The QRS-axis is between 60 and 90 degrees, which is physiological at this age. The negative T-waves in V1-V3 (V4) are also age-appropriately normal. Therefore, there is no reason for concern; the ECG is considered normal for the child's age.</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/79/feed" method="post" id="fivestar-custom-widget--2" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--4" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG OF A 3 YO BOY, IS IT NORMAL? 1/5</option><option value="40">Give ECG OF A 3 YO BOY, IS IT NORMAL? 2/5</option><option value="60">Give ECG OF A 3 YO BOY, IS IT NORMAL? 3/5</option><option value="80" selected="selected">Give ECG OF A 3 YO BOY, IS IT NORMAL? 4/5</option><option value="100">Give ECG OF A 3 YO BOY, IS IT NORMAL? 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.4</span></span> <span class="total-votes">(<span >5</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--2" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-e8fiiwBI6oWwl4Q_Of7PfDuVxa72G9snzXELudBLg50" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_2"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fecg-3-yo-boy-it-normal&amp;title=ECG%20%20OF%20A%203%20YO%20BOY%2C%20IS%20IT%20NORMAL%3F"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Mon, 31 Jul 2023 10:17:32 +0000 Dr A Röschl 857 at https://www.ecgguru.com https://www.ecgguru.com/blog/ecg-3-yo-boy-it-normal#comments Non-respiratory Sinus Arrhythmia https://www.ecgguru.com/blog/non-respiratory-sinus-arrhythmia <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/non-respiratory-sinus-arrhythmia"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/nichtrespiratorische%20Sinusarrythmie.jpg" width="2848" height="1895" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>This is the ECG of an 81-year-old man with hypertension. Currently, he has no complaints: no palpitations, no shortness of breath, no syncope, no chest pain. The rhythm is irregular, but all P-waves have the same shape. There is a non-respiratory sinus arrhythmia present, which is essentially the minimal variant of a sick sinus syndrome. There are no consequences for the patient resulting from this diagnosis.</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/79/feed" method="post" id="fivestar-custom-widget--3" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--6" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Non-respiratory Sinus Arrhythmia 1/5</option><option value="40">Give Non-respiratory Sinus Arrhythmia 2/5</option><option value="60">Give Non-respiratory Sinus Arrhythmia 3/5</option><option value="80">Give Non-respiratory Sinus Arrhythmia 4/5</option><option value="100">Give Non-respiratory Sinus Arrhythmia 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="empty">No votes yet</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--3" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-nvLTSlKhG2KxrFeMwhr9FuS8i55sFkK5kJFEdxofiE4" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_3"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fnon-respiratory-sinus-arrhythmia&amp;title=Non-respiratory%20Sinus%20Arrhythmia"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Wed, 26 Jul 2023 11:58:33 +0000 Dr A Röschl 851 at https://www.ecgguru.com https://www.ecgguru.com/blog/non-respiratory-sinus-arrhythmia#comments ECG Basics: Second-degree AV Block, Type II https://www.ecgguru.com/ecg/ecg-basics-second-degree-av-block-type-ii-0 <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-second-degree-av-block-type-ii-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/167%20AVB%20Type%20II%203%20to%202.jpg" width="1398" height="279" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>This rhythm strip was obtained from a man who was suffering an acute inferior wall M.I.&nbsp; There are ST elevation and hyperacute T waves.&nbsp; The rhythm is <strong>SINUS ARRHYTHMIA WITH SECOND-DEGREE AV BLOCK, TYPE II.&nbsp; &nbsp;</strong> There is also first-degree AV block.</p><p>There are more P waves than QRS complexes, with a 3:2 ratio.&nbsp; The atrial rate varies between 55 -68 beats per minute.&nbsp; The sinus rate speeds slightly after the dropped QRS in each group. The ventricular rate is about 40 bpm, with grouped beating. (Regularly irregular.)</p><p>The PR intervals are steady at 226 ms (slightly prolonged).</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/79/feed" method="post" id="fivestar-custom-widget--4" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--8" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: Second-degree AV Block, Type II 1/5</option><option value="40">Give ECG Basics: Second-degree AV Block, Type II 2/5</option><option value="60">Give ECG Basics: Second-degree AV Block, Type II 3/5</option><option value="80" selected="selected">Give ECG Basics: Second-degree AV Block, Type II 4/5</option><option value="100">Give ECG Basics: Second-degree AV Block, Type II 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4</span></span> <span class="total-votes">(<span >3</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--4" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-9ENi0iTECe1UmYkqfnpME_xgdcTQHpJ-ayI-aqAjBVE" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/rhythm-strip" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Rhythm strip</a></div><div class="field-item odd"><a href="/ecg/first-degree-av-block" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">First-degree AV block</a></div><div class="field-item even"><a href="/ecg/sinus-arrhythmia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Sinus arrhythmia</a></div><div class="field-item odd"><a href="/ecg/basic-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Basic ECG</a></div><div class="field-item even"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item odd"><a href="/ecg/second-degree-av-block-type-ii" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Second-degree AV block Type II</a></div><div class="field-item even"><a href="/ecg/av-block" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">AV Block</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_4"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-second-degree-av-block-type-ii-0&amp;title=ECG%20Basics%3A%20%20Second-degree%20AV%20Block%2C%20Type%20II%20"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Tue, 08 Dec 2020 21:31:26 +0000 Dawn 794 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-second-degree-av-block-type-ii-0#comments ECG Challenge: Guillain-Barre' Syndrome Patient https://www.ecgguru.com/ecg/ecg-challenge-guillain-barre-syndrome-patient <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-challenge-guillain-barre-syndrome-patient"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/GBS.jpg" width="1800" height="1206" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p class="MsoNormal">This ECG is probably not for the basic ECG interpretation class.<span style="mso-spacerun: yes;">&nbsp; </span>But, it presents a challenge for the experienced ECG Gurus and instructors out there.<span style="mso-spacerun: yes;">&nbsp; </span>We will leave it here for one week, to allow for comments.<span style="mso-spacerun: yes;">&nbsp; </span>On June 22, we will publish Dr. Jerry Jones’s comments.<strong><span style="font-size: 12.0pt; line-height: 107%; color: #00b050;">&nbsp;</span></strong></p><p class="MsoNormal"><strong><span style="font-size: 12.0pt; line-height: 107%; color: #00b050;">The Patient</span></strong><span style="mso-tab-count: 1;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span> This ECG is from a 44-year-old man. He was stricken with <a href="https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-sheets/Guillain-Barr%C3%A9-Syndrome-Fact-Sheet#3139_6">Guillain-Barre’</a> Syndrome when he was 32.<span style="mso-spacerun: yes;">&nbsp; </span>He doesn’t know what his ECGs showed when he was hospitalized with GBS. He knows of no abnormal lab results except for a high CK of 414, attributed to the muscle wasting with GBS.</p><p class="MsoNormal">When he was 43, he started having occasional light-headedness, and was found to have bradycardia around 50 bpm that did not increase with exercise.<span style="mso-spacerun: yes;">&nbsp; </span>A loop recording showed occasional bradycardia over the next several years.<span style="mso-spacerun: yes;">&nbsp; </span>This ECG is now five years old, and the patient says he no longer suffers from bradycardia or lightheadedness, only occasional palpitations and a sensation of “skipped beats”. He lives an active life, albeit with some residual lower extremity weakness from the GBS.</p><p class="MsoNormal">In order to comment on this ECG, it is necessary to “sign in” with an email address.<span style="mso-spacerun: yes;">&nbsp; </span>This is so we can attempt to keep Spammers off the site.<span style="mso-spacerun: yes;">&nbsp; </span>We do not use the email addresses or share them, and we will not contact you. We are looking forward to reading your comments.</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/79/feed" method="post" id="fivestar-custom-widget--5" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--10" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Challenge: Guillain-Barre&amp;#039; Syndrome Patient 1/5</option><option value="40">Give ECG Challenge: Guillain-Barre&amp;#039; Syndrome Patient 2/5</option><option value="60">Give ECG Challenge: Guillain-Barre&amp;#039; Syndrome Patient 3/5</option><option value="80" selected="selected">Give ECG Challenge: Guillain-Barre&amp;#039; Syndrome Patient 4/5</option><option value="100">Give ECG Challenge: Guillain-Barre&amp;#039; Syndrome Patient 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4</span></span> <span class="total-votes">(<span >3</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--5" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-iaxbsJmDnMNSGeM2kCSjW4wgvP1v_adxfpNcBveNThs" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-challenge" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Challenge</a></div><div class="field-item odd"><a href="/ecg/guillain-barre-syndrome" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Guillain-Barre&#039; Syndrome</a></div><div class="field-item even"><a href="/ecg/third-degree-av-block-1" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Third-degree AV block</a></div><div class="field-item odd"><a href="/ecg/junctional-rhythm" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Junctional rhythm</a></div><div class="field-item even"><a href="/ecg/sinus-arrhythmia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Sinus arrhythmia</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_5"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-challenge-guillain-barre-syndrome-patient&amp;title=ECG%20Challenge%3A%20%20Guillain-Barre%27%20Syndrome%20Patient"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Mon, 15 Jun 2020 19:45:50 +0000 Dawn 786 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-challenge-guillain-barre-syndrome-patient#comments Irregular Rhythm in a Young Person https://www.ecgguru.com/ecg/irregular-rhythm-young-person <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/irregular-rhythm-young-person"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/N110%20w%20sinus%20arrhythmia.jpg" width="2000" height="1384" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p class="MsoNormal" style="line-height: normal;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 14.0pt;">The Patient<span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp; </span></span></strong>This ECG is taken from a teenage boy whose mother was concerned that he has an “irregular pulse”.<span style="mso-spacerun: yes;">&nbsp; </span>He is otherwise very healthy, and has no complaints.</p><p class="MsoNormal" style="line-height: normal;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 14.0pt;">The ECG<span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp; </span></span></strong>The rhythm is irregular.<span style="mso-spacerun: yes;">&nbsp; </span>With such a short strip (12-Lead ECGs are often about ten seconds long), it is difficult to determine the exact reason for the irregularity.<span style="mso-spacerun: yes;">&nbsp; </span>One possibility is a sinus rhythm with PACs, which would not be unexpected in a young person.<span style="mso-spacerun: yes;">&nbsp; </span>The more likely interpretation is sinus arrhythmia, also very common in young people. <span style="mso-spacerun: yes;">&nbsp;</span>In a longer strip, we might be able to associate the rhythmic slowing and speeding of the rate with the patient’s respirations.<span style="mso-spacerun: yes;">&nbsp; </span>The P waves all look alike in each of the twelve leads. Different P wave morphology in the early beats would indicate PACs, but the similar P waves do not exclude PACs.</p><p class="MsoNormal" style="line-height: normal;">The PR interval is normal, the QRS duration normal, the QTc is normal.<span style="mso-spacerun: yes;">&nbsp; </span>The rate (average 68 bpm) is normal.<span style="mso-spacerun: yes;">&nbsp; </span>The frontal plane QRS axis is normal, with Lead II having the tallest QRS in the frontal plane (limb leads), and aVL small and biphasic.<span style="mso-spacerun: yes;">&nbsp; </span>R wave progression in the precordial leads is good, with the transition from negative to positive in V<sub>3</sub>.<span style="mso-spacerun: yes;">&nbsp; </span></p><p class="MsoNormal" style="line-height: normal;">The J point – the end of the QRS and beginning of the ST segment – is at the baseline in all leads except possibly V<sub>2</sub>.<span style="mso-spacerun: yes;">&nbsp; </span>Remember to measure the J point against the T-P segment, rather than the P-R segment. A tiny bit of elevation at the J point is not uncommon in young men, and is not a worry when there are no symptoms, and the ST segment has a normal shape.<span style="mso-spacerun: yes;">&nbsp; </span>The ST segments here are concave upward, which is normal.<span style="mso-spacerun: yes;">&nbsp; </span>T waves are usually upright, but it is within normal limits for young people to have some T wave inversion in right-sided leads (III, V<sub>1</sub>, V<sub>2</sub>).<span style="mso-spacerun: yes;">&nbsp; </span>We see that in this patient in V<sub>1</sub> and V<sub>2</sub>. <span style="mso-spacerun: yes;">&nbsp;</span></p><p class="MsoNormal" style="line-height: normal;">It is important to consider the patient’s age and gender when interpreting the ECG.<span style="mso-spacerun: yes;">&nbsp; </span>The presentation, including symptoms, history, medications, and abnormal physical findings are also important.<span style="mso-spacerun: yes;">&nbsp; </span>What might be abnormal in an elderly person with chest pain could be perfectly normal in a young, healthy person.<span style="mso-spacerun: yes;">&nbsp; </span></p><p class="MsoNormal" style="line-height: normal;">Now, we are more concerned about why this mom is checking her healthy child’s pulse.<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span><span style="mso-spacerun: yes;">&nbsp;</span>;-)</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/79/feed" method="post" id="fivestar-custom-widget--6" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--12" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Irregular Rhythm in a Young Person 1/5</option><option value="40">Give Irregular Rhythm in a Young Person 2/5</option><option value="60">Give Irregular Rhythm in a Young Person 3/5</option><option value="80" selected="selected">Give Irregular Rhythm in a Young Person 4/5</option><option value="100">Give Irregular Rhythm in a Young Person 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.5</span></span> <span class="total-votes">(<span >4</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--6" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-Rq7ByykT5BZjy1jC9QcRCjOsTVFKCnHUqnrkFgm_1so" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/normal-rhythm" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal rhythm</a></div><div class="field-item odd"><a href="/ecg/sinus-arrhythmia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Sinus arrhythmia</a></div><div class="field-item even"><a href="/ecg/young-patient-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Young patient ECG</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_6"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Firregular-rhythm-young-person&amp;title=Irregular%20Rhythm%20in%20a%20Young%20Person%20"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Thu, 28 Mar 2019 05:21:15 +0000 Dawn 766 at https://www.ecgguru.com https://www.ecgguru.com/ecg/irregular-rhythm-young-person#comments Jason's Blog: ECG Challenge of the Week for July 22-29. What are the causes of these patterns? https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-july-22-29-what-are-causes-these-patterns <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/jasons-blog-ecg-challenge-week-july-22-29-what-are-causes-these-patterns"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%201e-1a%20answer.png" width="765" height="509" alt="" /></a></div><div class="field-item odd"><a href="/blog/jasons-blog-ecg-challenge-week-july-22-29-what-are-causes-these-patterns"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%201e-2a%20answer.png" width="765" height="644" alt="" /></a></div><div class="field-item even"><a href="/blog/jasons-blog-ecg-challenge-week-july-22-29-what-are-causes-these-patterns"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%201e-2b%20answer.png" width="765" height="631" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>&nbsp;</p> <p><span style="font-size: small;">I recently performed both of these ECGs a few days apart during the same work week.&nbsp; They were recorded on an outpatient basis.&nbsp; It wasn’t until I recorded the second ECG that I realized I had a good pair of ECGs to illustrate this comparison.</span><br><br><span style="font-size: small;">At a superficial glance, both of these appear to represent the same thing and some people&nbsp;might even argue that both of these ECGs have identical interpretations but they would be wrong.&nbsp; One of these represents a conventional example that is <em>intrinsic</em> to the heart and it's conduction system.&nbsp; The other is a lesser-known example and is <em>extrinsic</em> to the heart.&nbsp; Admittedly, they do share similar characteristics however there are several contrasting features as well.<span class="MsoNormal">&nbsp;</span> </span><br><br><span style="font-size: small;"><strong style="mso-bidi-font-weight: normal;"><span style="text-decoration: underline;"><span style="color: blue;">Fig. # 1</span></span></strong> </span><br><br><span style="font-size: small;"><strong style="mso-bidi-font-weight: normal;"><span style="text-decoration: underline;"><span style="color: #c00000;">Patient's clinical data:</span></span></strong> &nbsp;68-year-old white man.&nbsp; </span><span style="font-size: small;">History of hypertension.</span><br class="MsoNormal"><br><span style="font-size: small;"><strong style="mso-bidi-font-weight: normal;"><span style="text-decoration: underline;"><span style="color: blue;">Fig. # 2</span></span></strong></span><br><br><span style="font-size: small;"><strong style="mso-bidi-font-weight: normal;"><span style="text-decoration: underline;"><span style="color: #c00000;">Patient's clinical data:</span></span></strong>&nbsp; 57-year-old black man. </span><br><br><span style="font-size: small;"><strong style="mso-bidi-font-weight: normal;"><span style="text-decoration: underline;">The computer interpreted <span style="color: blue;">Fig. # 2</span> as:</span></strong></span></p> <table class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-yfti-tbllook: 1184; mso-padding-alt: 0in 5.4pt 0in 5.4pt;" border="1" cellspacing="0" cellpadding="0"> <tbody> <tr style="mso-yfti-irow: 0; mso-yfti-firstrow: yes; mso-yfti-lastrow: yes;"> <td style="width: 6.65in; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;" valign="top" width="638"> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: normal;"><span style="font-size: small;">Marked sinus bradycardia with marked sinus arrhythmia 1st degree AV block</span><br><span style="font-size: small;">Voltage criteria for left ventricular hypertrophy</span><br><span style="font-size: small;">Abnormal ECG</span><br><span style="font-size: small;">When compared with ECG of <em style="mso-bidi-font-style: normal;">(deleted)</em></span><br><span style="font-size: small;">PR interval has increased</span></p> </td> </tr> </tbody> </table> <p class="MsoNormal"><span style="font-size: small;"><strong style="mso-bidi-font-weight: normal;">DO YOU AGREE WITH THE COMPUTER?</strong></span><br><span style="font-size: small;"><strong style="mso-bidi-font-weight: normal;"><span style="text-decoration: underline;"><span style="line-height: 115%; color: #009900;"><br>QUESTIONS:</span></span></strong>&nbsp; </span></p> <p><span style="font-size: small;"><span style="line-height: 115%;">What are the causes of the pauses and the "group beating"?&nbsp; Do either of these patients need a pacemaker?</span>&nbsp;<span style="line-height: 115%;"> <br><br><span style="text-decoration: underline;"><strong>Hint:</strong></span>&nbsp; In <span style="color: blue;">Fig. # 2</span>, pay careful attention to the sinus P-P intervals and their correlation with the timing of the pauses.&nbsp; Compare the <em style="mso-bidi-font-style: normal;">PR intervals</em> and their corresponding <em>RP intervals</em>.&nbsp; Also contrast the lengths of the longest and shortest RR intervals. &nbsp;This will help to differentiate it from <span style="color: blue;">Fig. # 1</span>.</span></span></p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/79/feed" method="post" id="fivestar-custom-widget--7" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--14" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for July 22-29. What are the causes of these patterns? 1/5</option><option value="40">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for July 22-29. What are the causes of these patterns? 2/5</option><option value="60" selected="selected">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for July 22-29. What are the causes of these patterns? 3/5</option><option value="80">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for July 22-29. What are the causes of these patterns? 4/5</option><option value="100">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for July 22-29. What are the causes of these patterns? 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >2.7</span></span> <span class="total-votes">(<span >3</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--7" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-0hFWw13mA_X11AxZZWp5hxe-KTOXZQeyElYxTersh4k" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_7"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fjasons-blog-ecg-challenge-week-july-22-29-what-are-causes-these-patterns&amp;title=Jason%27s%20Blog%3A%20ECG%20Challenge%20of%20the%20Week%20for%20July%2022-29.%20%20What%20are%20the%20causes%20of%20these%20patterns%3F"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Sun, 22 Jul 2012 05:09:42 +0000 jer5150 253 at https://www.ecgguru.com https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-july-22-29-what-are-causes-these-patterns#comments