ECG Guru - Instructor Resources - Ventriculophasic sinus arrhythmia https://www.ecgguru.com/ecg/ventriculophasic-sinus-arrhythmia en Jason's Blog: ECG Challenge of the Week for Feb. 17th - 24th. https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-feb-17th-24th <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-feb-17th-24th"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%202e%20ladder_1.png" width="788" height="533" alt="" /></a></div><div class="field-item odd"><a href="/blog/jasons-blog-ecg-challenge-week-feb-17th-24th"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%202f%20supplimental%201.png" width="787" height="519" 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="text-decoration: underline;"><strong>Patient's clinical data:</strong></span>&nbsp; 81-year-old black man<br><br>The computer interpreted this ECG as:&nbsp; <br>Sinus bradycardia 1st degree AV block<br>ST abnormality, possible digitalis effect<br><span style="text-decoration: underline;">Abnormal ECG</span><br><span style="text-decoration: underline;">When compared with ECG of</span> <em>(expunged)</em><br><span style="text-decoration: underline;">PR interval has increased</span><br><span style="text-decoration: underline;">Vent rate has decreased by <strong>23 BPM</strong></span><br><br>DO YOU AGREE WITH THE COMPUTER?</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/174/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 Jason&amp;#039;s Blog: ECG Challenge of the Week for Feb. 17th - 24th. 1/5</option><option value="40">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Feb. 17th - 24th. 2/5</option><option value="60">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Feb. 17th - 24th. 3/5</option><option value="80">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Feb. 17th - 24th. 4/5</option><option value="100" selected="selected">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Feb. 17th - 24th. 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4.4</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" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-GmXrwfMnnw2_ByoAamRHJdW5QXE6jpN7ODnyYftclxw" /> <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%2Fjasons-blog-ecg-challenge-week-feb-17th-24th&amp;title=Jason%27s%20Blog%3A%20ECG%20Challenge%20of%20the%20Week%20for%20Feb.%2017th%20-%2024th."><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> Sat, 16 Feb 2013 20:29:08 +0000 jer5150 401 at https://www.ecgguru.com https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-feb-17th-24th#comments LYME DISEASE CAUSING AV BLOCK https://www.ecgguru.com/blog/lyme-disease-causing-av-block <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/lyme-disease-causing-av-block"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Lyme%20Disease%201.png" width="782" height="508" alt="" /></a></div><div class="field-item odd"><a href="/blog/lyme-disease-causing-av-block"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Lyme%20Disease%202.png" width="765" height="525" alt="" /></a></div><div class="field-item even"><a href="/blog/lyme-disease-causing-av-block"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Lyme%20Disease%203.png" width="583" height="757" 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: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">We are now in the month of August. Lyme Disease Awareness Month was about 4 months ago in May but that doesn’t mean that the number of cases are in decline.&nbsp; As a result of the mild winter, deer populations are thriving and consequently deer ticks are booming.&nbsp; &nbsp; <br><br>Since I’ve already posted my answer to this week’s ECG Challenge, I thought I’d take this opportunity to issue a pertinent and timely public health/practice alert.<span style="mso-spacerun: yes;">&nbsp; </span><br><br>This particularly applies to those of you who live in <a href="http://commonhealth.wbur.org/2012/02/ultimate-lyme-disease-map"><span style="font-weight: normal;">“at risk” states.</span></a>&nbsp; Virginia itself is not considered a high risk state, but it certainly shares borders with states that are.&nbsp; Transitional zones extend well into the Central Virginia area where&nbsp;I live.&nbsp; <br><br>If you’re a healthcare provider who performs ECGs and/or conducts an initial review of them, then you should be on the lookout for the onset of any newly documented A-V blocks in your patient population.<span style="mso-spacerun: yes;">&nbsp; </span>On my daily job, I often find myself in the unique position of being the first person to discover changes in rhythm, rate, and/or waveforms.<span style="mso-spacerun: yes;">&nbsp; </span>You should be hypersensitive to the symptoms of Lyme disease and keep it on your diagnostic “radar”.<span style="mso-spacerun: yes;">&nbsp; Recently, I featured two examples of <a href="http://www.ekgguru.com/content/jasons-blog-ecg-challenge-week-july-22-29-what-are-causes-these-patterns" target="_blank">AV block</a> with one of them being new.&nbsp; In retrospect, I should have <em>suggested</em> Lyme disease to both of the doctors when I returned the ECGs back to them. &nbsp;</span>I, and some of my fellow cardiographic technicians, have noticed an increase of patients coming in with ticks embedded in their skin.<span style="mso-spacerun: yes;">&nbsp; </span>One of my coworkers said she discovered two ticks on the same patient during the course of performing their resting ECG.&nbsp; <span style="mso-spacerun: yes;">In order to properly perform an ECG, a certain amount of undress, disrobing, and skin exposure is mandatory.&nbsp; Just as hairdressers have been trained to recognize skin cancer on the scalp, I've been putting the word out for others to be on the lookout for ticks and/or suspicious rashes when performing ECGs.&nbsp; </span><span style="mso-spacerun: yes;">&nbsp;&nbsp;</span><br><br>Suspecting Lyme disease is especially true if you discover relatively young and otherwise healthy individuals exhibiting disproportionately <a href="http://www.ekgguru.com/content/sinus-tachycardia-high-grade-av-block" target="_blank">high-grade (advanced) AV blocks</a> such as the one I’ve posted above.&nbsp; It's probably safe to say that most medical professionals don't know that Lyme disease can cause atrioventricular (AV) blocks.&nbsp; In talking to my colleagues in cardiology, I've found out that a fair amount of them didn't know this fact.&nbsp; Lyme disease doesn't always lead to A-V block (only about 8% of cases do), but when left untreated, it increases the risk that it&nbsp;might progress to high-grade or even complete AV block which can&nbsp;contribute to death.&nbsp; <br><br></span><strong><span style="text-decoration: underline;"><span style="font-size: 12pt; line-height: 115%; font-family: 'Calibri','sans-serif';">Patient’s clinical data:</span></span></strong><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"> <span style="mso-spacerun: yes;">&nbsp;</span>31-year-old black man who reported recent rash 5-6 weeks prior to hospital visit.<span style="mso-spacerun: yes;">&nbsp; </span>Lyme titer came back positive at a level of 5.33.<span style="mso-spacerun: yes;">&nbsp; </span>Any level greater than 1.09 is considered to be positive.<span style="mso-spacerun: yes;">&nbsp; </span>During his hospitalization, this patient was reported to have a 9-second period of ventricular asystole for which he received a temporary pacemaker. <br><br>Personally, I’ve been a long-time resident of the Commonwealth of Virginia for over 31 years, and recently I’ve noticed an increase in stories being run by the local news media on both television and in print.</span><br style="mso-spacerun: yes;"><br><strong><span style="text-decoration: underline;"><span style="font-size: 12pt; line-height: 115%; font-family: 'Calibri','sans-serif';">Sources / References:</span></span></strong><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"> <br></span></strong><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">(1.)</span><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">&nbsp; </span></strong><a href="http://www.nbc12.com/story/14642482/lyme-disease" target="_blank"><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">Governor warns of Lyme disease as tick season continues</span></a><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"><br></span></strong><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">(2.)</span><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">&nbsp; </span></strong><span style="font-size: small; font-family: arial,helvetica,sans-serif;"><a href="http://reference.medscape.com/features/slideshow/skin-patches?src=emed_case_nl_0" target="_blank"><span style="text-decoration: none; color: #1171a7;">Strange Skin Patches with Syncope and Palpitations</span></a></span> (sign-in required)<br><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">(3.)</span><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"><span style="mso-spacerun: yes;">&nbsp;</span><strong style="mso-bidi-font-weight: normal;"><a href="http://www2.timesdispatch.com/news/2011/may/07/tdmet03-lyme-disease-on-rise-in-virginia-health-of-ar-1022790/"><span style="font-weight: normal;">Lyme disease on rise in Virginia, health officials say</span></a><br></strong></span><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">(4.)</span><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"><span style="mso-spacerun: yes;">&nbsp; </span><a href="http://wtvr.com/2012/05/16/ticks-are-out-and-lymes-disease-is-increasing/"><span style="font-weight: normal;">Ticks are out and Lyme disease is&nbsp;increasing</span></a></span></strong><a href="http://wtvr.com/2012/05/16/ticks-are-out-and-lymes-disease-is-increasing/"><br></a></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/174/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 LYME DISEASE CAUSING AV BLOCK 1/5</option><option value="40">Give LYME DISEASE CAUSING AV BLOCK 2/5</option><option value="60">Give LYME DISEASE CAUSING AV BLOCK 3/5</option><option value="80" selected="selected">Give LYME DISEASE CAUSING AV BLOCK 4/5</option><option value="100">Give LYME DISEASE CAUSING AV BLOCK 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 >2</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-PN_OwmU0nouSGVJQgpO7gvq6NELEp3hnMg_FxECAIK4" /> <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%2Flyme-disease-causing-av-block&amp;title=LYME%20DISEASE%20CAUSING%20AV%20BLOCK"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Thu, 02 Aug 2012 02:11:42 +0000 jer5150 278 at https://www.ecgguru.com https://www.ecgguru.com/blog/lyme-disease-causing-av-block#comments