Heart Transplant
Report:
Sinus rhythm 92/min
Another sinus rhythm, 66/min
Atrial âparasystoleâ
Small voltage
Comment:
This was, of course, a âtrick questionâ - except that the answer should suggest itself without even looking at the trace. Not many types of surgery can be diagnosed from their postoperative ECGs! It is even easier than the first sentence of the NEJM CPCs.
The slower, recipientâs, P waves are not conducted, since they cannot negotiate the surgical suture line between the recipientâs and the donorâs atrium.
Interestingly, there is a slight but definite rate variation in the denervated heart.
Low voltage can be a sign of transplant rejection, but was not that (clinically) in this case.
Fig 97. 74 year old woman in cardiogenic shock.
If you have any suggestions for or feedback on this report, please let us know.
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