Sinus Bradycardia

Report:

Sinus bradycardia 32/min

Short QT interval

QTc 0.31”

Comment:

Marked sinus bradycardia almost always signifies some form of sinoatrial block, often in the setting of sick sinus syndrome.

The short QT interval is more interesting. The most likely reason for both the bradycardia and the QT interval shortening is of course digoxin. Her level was 3.7 nmol/L (therapeutic range 1.0 – 2.6). Hypercalcæmia was suggested by the computer, but it is unlikely to cause profound bradycardia. Oddly enough, her calcium level remained unknown (was not requested) for almost two more years of frequent blood testing; then it was shown to be normal.

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