To use this site you must have Javascript enabled

doc2doc is a doctors community site with secure doctor forum & doctors social networking. Join for free today to get answers from your peers to your clinical questions

a young man with palpitations

False

Cardiology

a young man with palpitations

Read and join discussion threads related to cardiology

This young man (aged 24) presented to A&E with palpitations. I thought his ecg was rather interesting.

Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bc

Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dba

[
						{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:9a03e208-3b47-47c1-9067-501f757f5cbe","Timestamp" : new Date(2011, 6, 15, 16, 15, 56, 132)} ,					{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:63cd010a-a061-45f7-9f72-be2d695600cf","Timestamp" : new Date(2011, 6, 16, 14, 40, 55, 34)} ,					{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:47f10473-1167-490c-b722-3750b44d807a","Timestamp" : new Date(2011, 6, 16, 15, 9, 37, 519)} ,					{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:ff9d66fb-d6b5-4f9e-93d3-79e672fa32b3","Timestamp" : new Date(2011, 6, 18, 8, 45, 32, 817)} ,					{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:a52317c7-4833-496c-aea8-2486de95ddd3","Timestamp" : new Date(2011, 6, 22, 16, 53, 11, 193)} ,					{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:3b6dac93-e0f3-472b-bbd4-8b30d8d5a026","Timestamp" : new Date(2011, 6, 22, 18, 39, 10, 466)} ,					{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:8aaea659-f8b1-4576-9fd4-dbf015081fde","Timestamp" : new Date(2011, 6, 25, 8, 38, 21, 757)} ,					{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:43f19f16-4ddb-4a0a-9aea-b4c55021c634","Timestamp" : new Date(2011, 6, 27, 14, 35, 31, 197)} ,					{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:3734b847-864e-48d2-b6f7-ba7a36001c94","Timestamp" : new Date(2011, 7, 16, 8, 50, 6, 183)} ,					{"Key" : "Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:12ee73df-a055-4f9e-8b3f-67a3811d5dbaPost:1b85f09b-2d23-4bf3-922d-96d0dd822495","Timestamp" : new Date(2011, 7, 16, 8, 52, 40, 390)} 				]

Forums » Open clinical » Cardiology » a young man with palpitations

You must be logged in to contribute. Log in | Register

1 2 >> Last

Forums » Open clinical » Cardiology » a young man with palpitations

a young man with palpitations

posted at 15/7/2011 4:15 PM BST on bmj.com

sadian

Posts: 878
First: 17/6/2011
Last: 24/5/2013

This young man (aged 24) presented to A&E with palpitations. I thought his ecg was rather interesting.

New post Reply to this post

Re: a young man with palpitations

posted at 16/7/2011 2:40 PM BST on bmj.com

Deb_D

Posts: 493
First: 12/7/2010
Last: 25/5/2013

Can some thing please be done about the size of the images? Even with zooming I am having difficulty in properly visualizing the ECG.

I assure everyone that its not an excuse for not being able to interpret the ECG

New post Reply to this post

Re: a young man with palpitations

posted at 16/7/2011 3:09 PM BST on bmj.com

ranasaleem

Posts: 220
First: 10/12/2010
Last: 1/6/2012

Heart rate is 150/m; regualr
No p waves.
J point needs to be interpreted by an ECG.
Start with BB. If patietn is anxious, give benzodiazepines also.
If there is a murmur, send for XR chest and echocardiography.

New post Reply to this post

Re: a young man with palpitations

posted at 18/7/2011 8:45 AM BST on bmj.com

sadian

Posts: 878
First: 17/6/2011
Last: 24/5/2013

Sorry I can't do anything with the qualtiy of the ecg. Some more clinical details might be useful to you. He is visting the UK on a student visa from Pakistan - he had an echo there about 2 weeks before he came over and was told that his heart was enlarged.

New post Reply to this post

Re: a young man with palpitations

posted at 22/7/2011 4:53 PM BST on bmj.com

sadian

Posts: 878
First: 17/6/2011
Last: 24/5/2013

The ecg shows electrical alternans - I think it is best seen in V3. He had a large pericardial effusion and we drained about 1l. The working diagnosis was of TB.

New post Reply to this post

Re: a young man with palpitations

posted at 22/7/2011 6:39 PM BST on bmj.com

panos

Posts: 187
First: 11/3/2009
Last: 14/10/2012

Very interesting Sadian! I think you should publish it!

New post Reply to this post

Re: a young man with palpitations

posted at 25/7/2011 8:38 AM BST on bmj.com

sadian

Posts: 878
First: 17/6/2011
Last: 24/5/2013

Thank you - i'm glad you found it interesting - he has a classical CXR of pericardial effusion also but unfortunately all the admitting team saw was the AF!
best,
sadian

New post Reply to this post

Re: a young man with palpitations

posted at 27/7/2011 2:35 PM BST on bmj.com

Dean Jenkins

Posts: 195
First: 14/1/2009
Last: 17/5/2013

Here's another example of electrical alternans.

http://ecglibrary.com/elec_alt.html

Agree it's hard to see the ECGs on doc2doc

New post Reply to this post

Re: a young man with palpitations

posted at 16/8/2011 8:50 AM BST on bmj.com

drbanon

Posts: 33
First: 11/2/2011
Last: 2/5/2013

I agree this should be a good case for publishing. Both the EMJ and BMJ have short case reports now. I suspect the angle you should adopt is the 'differential diagnosis' of electrical alternans (which is essentially caused by excessive movement of the heart), therefore Pericardial effusion should certainly be considered.

New post Reply to this post

Re: a young man with palpitations

posted at 16/8/2011 8:52 AM BST on bmj.com

drbanon

Posts: 33
First: 11/2/2011
Last: 2/5/2013

New post Reply to this post

1 2 >> Last

	Suicidal behaviour is a disease By sken
	What would you do - post operative laparotomy with respiratory distress? By Deb_D
	Qatar jails a foreign teacher on charges of insulting Islam By kirked
	Spam? By mbillingsley
	Baby brain mistakes By monica.lalanda
	Medical students behaving badly By monica.lalanda
	OMICS Publishing Group threatens to sue Dr Jeffrey Beall By Matiram Pun
	Drinking largely sobers us again By Carolin
	Should castration of sex offenders be banned? By ljwatson
	Dangerous advice on diabetes? By Stagnaro

What do you think?

Latest discussions

Closed forum discussions

Recommended discussions

Forums » Open clinical » Cardiology » a young man with palpitations

a young man with palpitations

Re: a young man with palpitations

Re: a young man with palpitations

Re: a young man with palpitations

Re: a young man with palpitations

Re: a young man with palpitations

Re: a young man with palpitations

Re: a young man with palpitations

Re: a young man with palpitations

Re: a young man with palpitations

Forums » Open clinical » Cardiology » a young man with palpitations

	acute pancreatitis and cholecistectomy
	acute pancreatitis and cholecistectomy
	post stroke reviews in primary care - your views