P-Deformed VEBs
Report:
Sinus tachycardia 102/min
VEBs
Comment:
In most cases P waves are not large enough to show through the superimposed VEBs; their presence is inferred from the completely compensatory pause containing the VEB. Here, the P waves are very large and the QS VEBs have opposite direction to them; further, the P waves fall in the middle of the ectopic QS complexes.
The VEBs look QRS rather than QS in shape; another differential diagnosis is junctional RS beats preceded by an inverted P’ wave and very short PR interval expected in junctional beats. Both notions are easily dispelled by mapping of the sinus P waves in their expected location.
Below (Fig 184a) is the patient’s 12-lead ECG, showing RAD from a lateral infarction and marked RAA. With small standard lead voltage and right precordial T inversion, it suggests cor pulmonale with RAD from RVH. In this case the ECG is misleading: the patient’s problems (mitral incompetence, dilated LV and anterior infarction) were primarily left-sided.
The P waves are taller than the QRS complex in lead 2, used for monitoring in Fig 184 above.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and it's records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.