This is a straightforward EKG that everyone should know. We saw this patient a week ago.
He is 56-y-o-Hispanic man in ER with SOB.
What is the interpretation? What is next?
Sinus tachycardia, low voltage, Electrical alternance
Need vital signs. Check pulsus paradoxus.
Echo/pericardiocentesis
Exactly. Electrical alternans. Seen easier in some leads compared to others.
The patient had h/o lung cancer and received chemotherapy 3 years ago. His echo showed massive effusion and tamponade.
Presenting Echo:
during tab (bubble study):
after tab and drain:
er EKG after 400 cc of fluid removed is given below (and at the bottom I put the presenting EKG to compare them):
Post Tab
Presenting EKG (alternans):
Sinus tachycardia, low voltage, Electrical alternance
Need vital signs. Check pulsus paradoxus.
Echo/pericardiocentesis
Exactly. Electrical alternans. Seen easier in some leads compared to others.
The patient had h/o lung cancer and received chemotherapy 3 years ago. His echo showed massive effusion and tamponade.
Presenting Echo:
Post Tab
Presenting EKG (alternans):