Wednesday, February 16, 2011

Technology Trumps History.... Class?


All questions and inquiries other than those from CannedAm answered asap.

21 comments:

  1. Looks like wpw to me but I'm just a lowly medical student...

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  2. ah!
    then there's your problem! it IS WPW, and if you were in rounds you might have held onto that thought for fear of being wrong and then being ridiculed. so let me ask you a favor, briefly educate our readers on the EKG criteria of WPW and then i'll tell the interesting story behind this EKG.
    nice call

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  3. If I remember correctly, wpw is due to an accessory pathway between the atria and ventricles. This pathway allows preexcitation of the ventricles and can leads to tachyarrthymias. For, dx, the QRS has a slurred upstroke- delta wave. Tx is procainamide or flecainanide. There's probably a more eloquent description but that's what I remember

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  4. nicely done,
    short pr interval, slurred upstroke of the QRS called a delta wave, and a history of tachdysrhythmias etc... this case is very intersting and i'll pause for other comments but, as the title suggests, this person is doing just fine... this was an OMGWTF moment.

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  5. Do not interrupt American Idol 911!

    -SCRN

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  6. WPW seen on ECG alone not that concerning to me. The hx would be more concerning...Palps with syncope? Near syncope? Age? Occupation?
    CardioNP

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  7. Does the delta wave showing in v3 mean that the extra pathway is between LA and LV? Or could it be either side?

    Don't start learning ekgs for a few weeks, relying on dubins...

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  8. Errr...v6, sorry...on my phone.

    Ms1

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  9. Note to MDOD: don't save the file using the name of the rhythm! You ruined the mystery!

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  10. Is this a type B WPW? Also, was the patient on digoxin?

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  11. cardio np,
    would it worry you if this young person was one signature away from going to a special forces training camp for three months of, uh... special forces training? if not, would it bother you if this persons father died at age 34 from a 'heart attack'? i nearly crapped my pants because this was just a routing ekg on someone who has been in service for a while and i almost missed it... the computer didn't though!

    frank,
    as a former military man yourself i know that you will recognize WPW as meaning 'whiskey papa whiskey'. and sorry about those oak trees, i may hate 'bama now more than florida.

    as to the other good questions about WPW... i don't know... i just know what to do when i see it.

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  12. When I was in the Navy a buddy of mine cropped up with this. He had it ablated and was able to stay in, but apparently it grew back. He was separated when he refused a second ablation.

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  13. I always thought "WPW" was one of those fake diseases, like hypoglycemia, ADD, or fibromyalgia, you know, like how Mapquest has those fake towns that only show up on Mapquest, so if you try and sell there Map, it'll have that fake town, you know, like "Homo-ville" or "Boner-town".
    Where was I, oh yeah, one of those fake diseases to make it easier to spot the malingerers/hypochondriacs/nuts, a little shorthand that only us Docs know, sort of like how Mossad Assassins have that secret handshake...

    Frank

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  14. Oh yeah,
    sorry about UGA being poisoned, I mean getting Leukemia, and you do know Tech has a Nuclear Reactor?? ON CAMPUS???
    Just sayin...
    and if someone just happens to dig up Bear Bryant and George Wallace and arranges them in a Compromising sexual position at the very site on the University of Alabama Campus where George Wallace "Stood in the School House Door" for a whole 10 seconds until the Feds showed up...
    it won't be me...
    not that you'll be able to prove anyway.

    Frank

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  15. Do we make them look it up along with bundle of Kent or do we tell them Wolff–Parkinson–White syndrome?

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  16. Oddly, I went to school at Alabama (Roll Tide!) and I knew what this was only because a guy I was on drumline with had it. Learned all about it on the practice field.

    ~rn in the or

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  17. common 911, im a pharmacist and I knew that was WPW

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  18. So, 911,

    I was in the ER last night, because I do things like that. Anyway, the attending hands me an EKG and says "bet you've never seen this before. I'll buy you coffee if you figure it out."

    10 points for the M.D.O.D. blog. I take lots of milk.

    --MS1

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