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Related Concept Videos

Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

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Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
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ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Cardiac Action Potential01:30

Cardiac Action Potential

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Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
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Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

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Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
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Electrophysiology of Normal Cardiac Rhythm01:19

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The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase...
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Disturbances in Heart Rhythm01:29

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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
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Transient apical dyskinesia with a pacemaker: Electrocardiographic features.

Iván J Núñez-Gil1, Gisela I Feltes1, Hernán D Mejía-Rentería1

  • 1Cardiology Department, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|April 5, 2015
PubMed
Summary

Transient apical dyskinesia, or Takotsubo syndrome, mimics heart attacks but has normal arteries. This case shows evolving ECG changes can occur even with a pacemaker.

Keywords:
Apical ballooning syndromeElectrocardiogramElectrocardiogramaMiocardiopatia TakotsuboPacingSíndrome de balonização apical com balãoTakotsubo cardiomyopathy

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Area of Science:

  • Cardiology
  • Neurology

Background:

  • Transient apical dyskinesia syndromes (TADS) mimic acute coronary syndromes (ACS).
  • TADS are characterized by normal coronary arteries and rapid, complete resolution of cardiac wall motion abnormalities.
  • Distinguishing TADS from ACS is crucial for appropriate patient management.

Observation:

  • A 73-year-old woman presented with chest pain and elevated troponin levels.
  • Cardiac imaging revealed apical hypokinesia with normal coronary arteries.
  • The patient had a history of pacemaker implantation in 2001.

Findings:

  • Electrocardiogram (ECG) alterations evolved over time despite continuous pacemaker pacing.
  • These dynamic ECG changes resolved completely after hospital discharge.
  • The clinical presentation and diagnostic findings were consistent with Takotsubo syndrome.

Implications:

  • Takotsubo syndrome can present with evolving ECG alterations even in patients with pacemakers.
  • This case highlights the importance of considering TADS in the differential diagnosis of chest pain, irrespective of cardiac device presence.
  • Further research may elucidate the mechanisms underlying ECG changes in Takotsubo syndrome during pacemaker use.