Electromechanical Association: Spurious VT
Report:
Sinus tachycardia.
Incomplete RBBB.
Movement artefact.
Comment:
The movement artefact occurs at the same rate as the pulse. The patient had a forceful precordial impulse, which visibly moved the lead attachment. I could not reproduce the original tracing from the top strip exactly, as it would have involved sticking multiple âbuttonsâ on the patientâs chest. Why did I bother? I wanted it for this Library.
This is one of the differential diagnoses of âbroad-complex tachycardiaâ! Precordial movement artefacts are invariably less marked on 12-lead ECGs, due to better filtering, but can be striking nevertheless.
268. 43 year old woman with pulmonary-renal syndrome due to focal crescentic glomerulonephritis, monitored during mechanical ventilation in the ICU. Current treatment included methylprednisolone, cyclophosphamide, dopamine, dobutamine, antibiotics and TPN. What else would you suggest?
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