Atrial Fibrillation
- Respiratory asked by Jafred
- Trinitroglycerin asked by Dermu Rea
- How to investigate a nodular goitre? asked by Razel Joy
- Hypertension asked by Sanchez
- Asthma and Asthma Treatment Plan asked by ritika
Atrial Fibrillation - ECG Case Discussion
This ECG was recorded from a 60-year-old man being treated as an out-patient for severe congestive cardiac failure. What might be the diagnosis of the underlying heart condition and what would you do?
- Atrial fibrillation
- Ventricular rate 75-200/min
- Normal axis
- Normal QRS complexes
- Downward-sloping ST segment depression, especially in leads V5, V6
The ventricular rate is not adequately controlled, though the ST segment depression suggests that he is taking digoxin. There are no changes to suggest ischaemia.
In the absence of clinical or ECG evidence of ischaemia, possible diagnoses include rheumatic heart disease, thyrotoxicosis, alcoholic heart disease, and other forms of cardiomyopathy.
Echocardiography is necessary. The serum digoxin level must be checked and the digoxin dose increased if appropriate. In addition to digoxin, the patient will need an angiotensin-converting enzyme inhibitor, a diuretic and, probably, anticoagulants. Beta-blockers must be considered once his cardiac failure is controlled.
Amyloidosis
Thyroid Symptoms & Signs
Simvastatin
Abnormal Cervical Smear
Hodgkin Lymphoma
Biochemistry-Mnemonics
Our mission is to provide a free, reliable and first-class education to everyone.
Rish Academy is a nonprofit organization.
Every little bit counts and is appreciated.
Find us on
