ECG Case: 40-year-old Woman with 'Extra Heart Beats'

by Joseph Alpert, MD

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    00:01 Alright, now that we've talked about ventricular arrythmias, let's take a case.

    00:05 Here's a 40-year-old vigorous female.

    00:08 She's seen in the office and complains about occasional 'extra heart beats'.

    00:12 She feels her heart going flip flop. Feels like the heart's doing somersaults and then pausing.

    00:18 So, she has palpitations and here's her ECG.

    00:23 Look at the ECG and see if you can recognize what's going on.

    00:34 Notice that there are extra beats occurring early and that the QRS is very differently oriented and different shape from the normal rhythm.

    00:44 And the ST segment is in the opposite direction.

    00:48 If you looked at the rhythm strip down at the bottom, you'll see first there's the standard and then you'll see normal beat, normal beat PVC.

    00:57 Normal beat, normal beat PVC. Normal beat, normal beat PVC.

    01:02 Notice QRS is wide, very different from the normal beat, and the ST and T wave are oppositely directed from the direction that the QRS is taking.

    01:13 So, these are single, premature ventricular contractions and are usually benign in the absence of heart disease.

    01:20 Sometimes if the patients has been drinking a lot of coffee, taking a lot of caffeine, the patient has been smoking, or the patient has been excited or frightened, you will see some PVCs. They can be benign.

    01:33 Thank you very much for attending this lecture.

    01:36 I look forward to talking with you in the next one.

    About the Lecture

    The lecture ECG Case: 40-year-old Woman with 'Extra Heart Beats' by Joseph Alpert, MD is from the course Electrocardiogram (ECG) Interpretation.

    Included Quiz Questions

    1. No progression: benign
    2. Progression to atrial fibrillation
    3. Progression to ventricular tachycardia
    4. Sudden cardiac death
    5. Progression to ventricular fibrillation

    Author of lecture ECG Case: 40-year-old Woman with 'Extra Heart Beats'

     Joseph Alpert, MD

    Joseph Alpert, MD

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