A patient was brought to the hospital after briefly losing consciousness due to

Question

A patient was brought to the hospital after briefly losing consciousness due to a fall in blood pressure. Her ECG displayed a wavy baseline between QRS complexes, with an estimated atrial rate of approximately 600 beats per minute. Afterward, a normal sinus rhythm was restored with a PR interval of 0.16 sec; however, occasional runs of PVCs were observed. Premature ventricular contractions (PVCs).

A. What condition did the ECG indicate when the patient was brought to thehospital? How might this have caused a momentary loss of consciousness?

B. What does a normal sinus rhythm with a P-R interval of 0.16 sec indicate? What are PVCs and what could a run of them look like to the patient?

Explanation / Answer

Answer: (A) The condition that ECG indicated when patient was bought to the hospital is premature ventricular contractions (PVC) that led to inadequate artrial blod flow to organs or hemodynamic compromise. Patient can suffer loss of conciousness due to reduced cerebral blood flow. The shortened ventricular filling time with the ectopic beats led to decreased stroke volume thus reduced cardiac output. PVCs can be caused by cardiac disorders or by any number of physiological stressors, such as infection, illness, surgery or trauma.

(B) A normal sinus rhythm with a P-R interval of 0.16 sec indicates sinus arrhythmia.It is usually asymptomaic. PVCs are premature ventricular contraction as they occur before regular heartbeat.PVCs are characterized by premature and wavy shaped QRS complexes that are unusually long.These complexes are not followed by a P wave, and the T wave is large and usually oriented in a direction opposite the major deflection of the QRS.

Patients with premature ventricular contractions sometimes report palpitations in the chest and in the neck.Occasionally there can be loss of conciousness due to reduced cerebral blood flow.Other than that patients with mild infrequent premature ventricular contractions often report no symptoms (asymptomatic) and are unaware of their premature ventricular contractions.

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