Calcium in Electromechanical Dissociation
Report:
Supraventricular tachycardia, probably sinus, 180/min
Third degree AV block
Junctional escape rhythm 26/min
Short QT interval consistent with hypercalcæmia
Comment:
Electromechanical dissociation (EMD) is not an ECG diagnosis. Sometimes the closed chest massage artefact provides a clue, but this is not seen here: CPR had been stopped earlier.
The recordings often look like this one in young people with healthy hearts given large doses of adrenaline and calcium during EMD.
The strips below are from another patient, whose EMD was caused by myocardial free wall rupture. He received 20 cc of 10% CaCl2 during and after the top strip (in 1977). Note again the marked shortening of the QT interval in the lower strip.
It is convenient to remember that only two factors shorten the QT interval: hypercalcæmia and digoxin (which releases intracellular calcium). This is one of the shortest differential diagnoses in internal medicine; distinction students have to add hyperthermia, vagal stimulation175 and a normal kangaroo heart176!
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.