4/30/2023 0 Comments Wide complex ivcd![]() Any ST depression in V2 and V3 is posterior OMI un.A man in his 40s with epigastric pain and a dynami.See search here.Īnother case of Bidirectional Ventricular Tachycardia A Southeast Asian with Tachycardia and Hypotension after taking a dangerous herbal medication (Bidirectional Ventricular Tachycardia from Aconite Poisoning) Propofol has been reported as a treatment for VT caused by catecholamine surge. VT can be caused by catecholamine surge in an otherwise relatively healthy heartĤ. Stress cardiomyopathy can be caused by a catecholamine surge, which has many etiologies including Subarachnoid hemorrhageģ. In combination with elevated troponins (250 ng/mL - NOT high sensitivity), these findings were thought to be due to stress cardiomyopathy (takotsubo).ġ. coronary vs noncoronary mechanisms-is unclear on this study). There is definite akinesis of the mid-lateral and basal anterior segments. Regional wall motion abnormality-anterior akinetic Regional wall motion abnormality-lateral akinetic Normal estimated left ventricular ejection fraction The estimated left ventricular ejection fraction is 59%. The patient was intubated for his mental status and additionally so that he could be put on a propofol infusion in order to blunt the catecholamine surge, after which the rhythm stabilized. SAH often causes a catecholamine burst and this can result in stress cardiomyopathy (takotsubo), and/or ischemia, with associated VT. With the combination of headache after exertion, followed by sudden collapse with altered mental status, in a previously healthy patient, subarachnoid hemorrhage was strongly suspected. Smith's ECG Blog ) - among potential mechanisms for explaining variation between a limited number of QRS morphologies during VT include: i) A single VT circuit with more than a single exit site ii) More than a single VT circuit and/ or, iii) Shifting conduction properties that alter the activation sequence ( Liu & Josephson - Circ Arrhythm Electrophysiol 4:2-4, 2011 ). As in the case of pleomorphic VT that I presented ( in the Jpost in Dr. Pathway of VT reentry may vary - that at times part of the pathway mayĬontain one of the bundle branches - and I suspect that may be what is This to continue if this was bidirectional VT with 2 different Suspect this may reflect retrograde P waves - and I wouldn’t expect Vertical lines that I drew in V1, V4) that continues precisely on time! I This being bidirectional VT - is that there is a deflection ( RED The QRS is wide - and looks to be of ventricular etiology. The ventricular rhythm looks quite regular.
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