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Q@Q time ⑥ - cardio69
#1
http://upload.medbullets.com/question/52...0strip.jpg

Most appropriate next step of management?
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#2
Q doesnt open up for me ; gives an error msg
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#3
http://i.imgur.com/0PGL39i.png?1
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#4
I see bradycardia
High T waves
long and short PR intervals
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#5
@cardio, I think this is a third degree block. I am seeing P wave and QRS complex dissociation. P waves appear at relatively regular intervals from each other and so do QRS complexes but they are not associated w/ each other.
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#6
Sorry, the question was about treatment. Well, I think that would depend on the cause. Treatment will vary w/ beta-blockers overdose, digitalis overdose, etc. I think excess calcium channel blockers can also cause it.

Unless I am mistaken and it is not a third degree block Smile.
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#7
I came late as usual : pacemaker
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#8
Here P wave has no relation to QRS complex (Always more P than QRS)
Clinical pat with “complete” block will present with minimal to to none symptomatology but if you get pat you not gone let pat go.

Manage symptomatic pat med &/or pacing.

If “nodal blocks” may ting to atropine & infranodal blocks are not gone respond to it or or other med that make it worse AV nodal conduction. IF there is no or incomplete response to atropine-> transcutaneous cardiac pacing (YOU SHOUID KNOW the end road transvenous pacing for almost all pat and that’s what you’re your FA preach on.

Pat blackout/ or syncope ( stroke Adams attack), dizziness, Pulse usually brady less than 40/min. BP: high PP ( High systolic & nomr diastolic) JVP large a wave “a” /cannon.
Atropine -> pacemaker.

@Alina "Well, I think that would depend on the cause" not ans I was looking for base on your FA, nice going on Dx.

@djdlbhp and that what your ans for nb Q. As ppl try ans after post of ECG here (:
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#9
@cardio, good explanation. Thank you. I haven't read any systems in FA yet. When I will, I will pay attention. But yeah, very thorough explanation.
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#10
@alina972 you gone do great. I seen the way you break the Q apart & not afraid to make mistake. Did you start on UW?
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