Analysis Of 10 Second 6-Lead ECG And Holter Monitoring

The abnormally fast heartbeat caused by SVT, lasts in episodes lasting for several hours. During an episode

Apical hypertrophic cardiomyopathy is a disease that mainly affects the apex of the heart and does not cause any obstruction. [1] These abnormalities in the heart muscle can cause a wide variety of symptoms. As the heart becomes stiff it increases the pressure in the left ventricle which can push blood back into the lungs, causing shortness of breath in exercise. Chest pain can occur as there is not enough oxygen available to the cardiac muscle due to insufficient blood supply. Palpitations and lightheadedness, along with other conditions can occur as a result of HCM. In addition to these discomforting symptoms, the patient may develop an arrhythmias that often goes unnoticed. An arrhythmia takes place as the electrical conduction of the heart is disturbed by the abnormal scattering of myocytes. The two most common arrhythmias are atrial fibrillation causing palpitations, and ventricular tachycardia that can be life threatening causing sudden death. Both conditions can be controlled with medication. [4]

At the latter end of the p-q interval, atrial contraction occurs forcing additional blood into the ventricles. At the beginning of the QRS interval on an ECG reading, the mitral valve closes and the ventricles are at EDV (135ml). During the QRS interval, ventricular contraction occurs increasing the pressure in the ventricle and the aorta. When the pressure continues in the ventricle exceeds the pressure in the arteries, the aortic valve opens and blood is ejected. The increased pressure continues through the t peak. The ventricles are now in ESV (65ml) and the aortic valve is closed. Now the ventricles are relaxed causing pressure to fall and the cardiac cycle starts over again. This ECG reading was from a normal tracing. Keep in mind that an ECV is easy to obtain, but there are some subtleties that are very complex.

Tachycardia: Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate. When the heart beats rapidly, the heart pumps less efficiently and provides less blood flow to the body and the heart. The rapid heartbeat increases the workload and oxygen demand of the heart. Problems will occur with the heart as tachycardia persists over time. The heart is maintaining less oxygen, which will lead to an MI due to death of the myocardial cells. Patient will start to have angina because of this. Tachycardia is noted in many diseases and disorder like: fever endocarditis, anemia, HTN, pericarditis, abnormal heart impulses, anxiety, older age, sleep apnea, COPD, electrolyte imbalances, and many more.

Cardiovascular. Client denies chest pain, palpitations, murmurs, any arrhythmias, hypertension, awakening at night with shortness of breath, or dizzy spells. Client has not had an electrocardiogram.

Risk for having CAD or established CAD, previous MI or heart failure with decreased ejection fraction and ventricular arrhythmias are the known risk factors for SCD[17, 136]. The estimated incidence rate of SCD in infants, children, adolescents, and young adults is about 1.3 to 8.5 per 100,000 patient/years [137] but it still costs to thousands life per year. Sudden infant death syndrome accounting for approximately 10% of the crib death is believed to be due to cardiac arrhythmia or long QT syndrome [138]. A study suggest that out of 158 deaths of American athletes, 30% were due to hypertrophic cardiomyopathy and 13% due to abnormal blood circulation, 10% due to increased cardiac mass due to cardiomyopathy [139]. Another study suggest 20% death due to CAD and 10% deaths due to right ventricular cardiomyopathy/ dysplasia in young population [140]. Patients suffering from SCD with normal heart or without any cardiac disease history, on autopsy show structural abnormalities. Sudden unexplained deaths are also a major concern in epidemiology of SCD and careful post-mortem and histological examination can play a vital role [17]. In a study with 270 autopsies 55 were found to have structural heart disease and a specific cause for death were found in 180 cases with 65% having CAD, 14% with congenital anomalies and 11% with myocarditis. Left

Even though HCM is a common genetic heart condition, there is no cure. However, there are multiple treatments used to relieve symptoms and prevent sudden cardiac death. The specific treatment prescribed varies based on the severity of the condition. Medications are used to relax the heart muscle and slow the heart rate. Doctors may use beta blockers, calcium channel blockers, or other medications to control heartbeats. Sometimes a person with HCM will use blood thinners to reduce the risk of blood clots in the heart. In addition to medications, a patient can get surgery to remove the thickened part of the heart. Septal myectomy is an open-heart procedure in which the surgeon removes part of the thickened septum, improving the blood flow and

Particularly heart beat irregularities (atrial fibrillation), disease of the heart valves, congestive heart failure or recent heart attack.

electrocardiograph. The lead that related most closely to the mean QT (highest correlation coefficient) was deemed most accurate. The results concluded that the most accurate lead was lead V6, followed by II and V2, respectively.

Electrocardiographic changes can include left ventricular hypertrophy with repolarisation changes with T wave inversion and deep Q waves. In family members carrying HCM gene mutations, the electrocardiogram may demonstrate only minor abnormalities. The presence of non-sustained ventricular tachycardia, a risk factor for sudden death, should be tested for by means of Holter monitoring (Maron et al., 2003). At present, the diagnosis of HCM relies on echocardiography revealing symmetric or asymmetric hypertrophy. Secondary causes of hypertrophy, including valvular disease or systemic hypertension, should be excluded. 2D imaging of the left ventricle by echocardiography can confirm the diagnosis in affected patients. The ejection fraction, a measure of left ventricular systolic function, is typically preserved but there is usually evidence of diastolic dysfunction. These can be measured by tissue Doppler ultrasonography, which can show diastolic dysfunction before the development of hypertrophy (Maron, 2002). Histologically, HCM is characterized by cardiac myocyte disarray and fibrosis. Myocyte death and myocardial scarring may be present and coronary arteries may have thickened walls. This pathology can promote ventricular tachycardia and ventricular fibrillation (Maron, 2002).

Crystal is a 20yo, G2 P1001, who was seen for a follow-up ultrasound assessment. The patient’s primary issue is the development of a postpartum cardiomyopathy after her 1st delivery in 2015. She also reportedly had an anti-M antibody but all of her antibody screens have been negative including one 3 weeks ago. She recovered from the cardiomyopathy and overall is asymptomatic. Her BP was normal today at 127/76 and her heart rate was 98. She states that she actually came to triage 3 weeks ago and had an echocardiogram and we obtained this record and ejection f4raciton is normal at 61.5% and no abnormalities were noted on the echocardiogram. She does have a history of a previous cesarean delivery and is interested in a repeat. In addition,

ECG : ventricular rate 54 beats/min, HR varying from 39 to 60 during a 45 minute period of monitoring, infrequent PVCs, ST elevation in leads II, III and avF indicating inferior injury or ischemia secondary to acute MI.

Regular electrical impulses are sent within the conduction system of the heart prompting contraction (Marieb, 2015). These electrical signals can be identified and documented by the use of an electrocardiography (ECG) machine. In a familiar ECG recording, three waves will occur; The P wave, QRS complex and

In addition, scientists have found that genetics also plays a role in cardiac arrhythmias and that in some cases patients have commented that they had no symptoms before they succumbed to some form of episode of cardiac distress, like a sudden heart attack. This has proven to be standard for many different forms of arrhythmias, whether it’s due to genetics or not. One such case is the long QT syndrome (LQTS) which is estimated to affect one in every 5000 people and is recognized as a family disorder, frequent in children during their childhood years (Wilde, and Bezzina 1352–1358.) Patients with this disorder can have symptoms of a fluttering heartbeat, shortness of breath, and chest pain, while other patients might not experience any symptoms at all (Wilde, and Bezzina 1352–1358.) Another known disorder is cardiac conduction disease, which is mostly due to some form of cardiac injury (Wilde, and Bezzina 1352–1358.) Symptoms for this

Recording an electrocardiogram or ECG, is a procedure which is performed daily all over the United Kingdom by thousands of healthcare workers and in particular nurses (Jacobson, 2000). The way in which this procedure is performed varies from geographical location to location and occasionally even more so, between staff on the same ward (Amos, 2000). This reason stated by Amos (2000), formed the basis of my decision to choose this topic.