This is an 42 year old female with a 4 month history of palpitation episodes with fast AF... Here you will see five ECG's captured from the patient... The patient is aware of these attacks happening and puts herself in the supine position and it reverts then back to NSR.
Over the last 24 hrs the patient is having multiple attacks and each time it reverts by itself by lying supine. You can see the patients first blood pressure on the first strip recorded.
Today is the first time the patient as felt SOB with these attacks... Lungs sounds (clear) bilateral equal breath sounds, and spO2 was 96% on air... P/t was also looking well perfused (pink)
PMH: AF and back problems only.
1) What's your interpretation of these ECG's (please refer which ECG you are talking about... ie 1,2,3,4,5,)?
2) Why does this fast AF revert after lying supine?
3) How would you treat this patient?
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The ECG shows A Fib in the first ECG.It is reverted to NSR by lying supine everytime.
ReplyDeleteIn my opinion she might be having (Left) Atrial Myxoma which has the tendency to give rise to arrhythmias like A fib. The SOB felt by the patient may be due to complete occlusion of the AV Ring ( Mitral ) in this case while some Extrasystoles may be due ischemic events. However this is very interesting ECG. {mobin18}
Further to the management of this patient she would benefit from Echo /Doppler study to plan for her future. If the diagnosis of Atrial Myxoma is confirmed on Echo, surgical removal of the same is indicated.
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