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Electrocardiographic artifact potentially misleading to the wrong management
Srishti Sareen1, Mannu Nayyar2, Brian Wheeler1
1Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
Parkinson's disease tremors can mimic atrial flutter (AF) on ECGs, leading to misdiagnosis. Recognizing these artifactual changes is crucial to avoid unnecessary treatments and hospitalizations for patients with arrhythmias.
Area of Science:
- Cardiology
- Neurology
Background:
- Atrial flutter (AF) is a common supraventricular tachyarrhythmia.
- Parkinson's disease (PD) presents with motor symptoms like tremors.
- Accurate electrocardiogram (ECG) interpretation is vital for patient management.
Observation:
- A patient with Parkinson's disease presented with chest pain and an ECG initially interpreted as AF.
- The patient exhibited resting hand tremors at 6-8 Hz.
- Specific ECG features raised suspicion for artifact rather than true AF.
Findings:
- A repeat ECG revealed normal sinus rhythm.
- Subsequent 48-hour Holter monitoring confirmed consistent sinus rhythm.
- The ECG findings were attributed to tremor-induced artifacts.
Implications:
- This case highlights the importance of differentiating artifactual ECG changes from true arrhythmias.
- Misinterpretation of ECGs in patients with tremors can lead to unnecessary interventions.
- Awareness of tremor artifacts can prevent inappropriate treatment and hospital admissions.
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