EKG Cases

Question 1

LB: What medications can be administered to someone with torsade de pointe to lower the QTr interval?

Answer 1

Magnesium and bicarb

Question 2

LB: What is the typical cause of torsades?

Answer 2

Prolonged QT interval due to drugs, typically anti bipolar

Question 3

LB: If tachycardia resolves with administration of adenosine, what does that tell about the origin of the tachycardia?

Answer 3

AV nodal dependent tachycardia (such as AVNRT). It rules out atrial tachycardia.

Question 4

LB: What are some EKG signs for right sided strain on the ventricle and atrium?

Answer 4

Hyperacute P waves show atrial enlargement
Right axis deviation (shown by deep S wave in lead I)
Presence of Q wave in lead III
Inverted T wave in lead III

Question 5

LB: What are some causes of right sided heart strain?

Answer 5

Anything that would cause increased resistance in the pulmonary circuit (COPD, pulmonary HTN, PE)

Question 6

LB: What types of anti arrhythmic drugs can be used as rescue drugs in torsades?

Answer 6

Class 1B antiarrhythmic drugs (ex. Lidocaine)