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arrhythmia

Sonopath Forum

Sonopath Forum

arrhythmia

– 10 year old MN Cockapoo with a very irregular arrhythmia on auscultation found on routine wellness exam

– no clinical signs of heart disease, no murmur, not unwell at all

– bloodwork pending

– echo – pretty normal except for mild- moderate TR with max vel. 2 m/s; normal LA, normal LV, right heart unremarkable, Aorta and PA velocities normal (would post but nothing exciting to show!)

– so this does not appear to be due to structural heart disease

Any thoughts on what may be causing this?

– 10 year old MN Cockapoo with a very irregular arrhythmia on auscultation found on routine wellness exam

– no clinical signs of heart disease, no murmur, not unwell at all

– bloodwork pending

– echo – pretty normal except for mild- moderate TR with max vel. 2 m/s; normal LA, normal LV, right heart unremarkable, Aorta and PA velocities normal (would post but nothing exciting to show!)

– so this does not appear to be due to structural heart disease

Any thoughts on what may be causing this?

 

Comments

Peter
April 22, 2014 at 6:34 pm -

Hi!
Very difficult to read –

Hi!

Very difficult to read – there seems to be a lot of “baseline-compensated” artifacts. The QRS complexes are narrow and there seems to be a P-wave in front of every QRS-complex and the other way around. Still, I cannot determine the PQ-intervals because I cannot enlarge the ECG sufficiently. Could be either Sinus-arrhythmia or some supraventricular arrythmia. A at least 3-lead ECG would be required here. I think the varying QRS-amplitudes are artificial (no pericardial effusion was visible…)

Sorry for this kind of nebulous interpretation – sometimes I envy the human doctors their compliant patients 🙂

 

Best regards!

 

Peter

Peter
April 22, 2014 at 6:34 pm -

Hi!
Very difficult to read –

Hi!

Very difficult to read – there seems to be a lot of “baseline-compensated” artifacts. The QRS complexes are narrow and there seems to be a P-wave in front of every QRS-complex and the other way around. Still, I cannot determine the PQ-intervals because I cannot enlarge the ECG sufficiently. Could be either Sinus-arrhythmia or some supraventricular arrythmia. A at least 3-lead ECG would be required here. I think the varying QRS-amplitudes are artificial (no pericardial effusion was visible…)

Sorry for this kind of nebulous interpretation – sometimes I envy the human doctors their compliant patients 🙂

 

Best regards!

 

Peter

Pankatz
April 22, 2014 at 8:53 pm -

Thanks Peter!
The patient was

Thanks Peter!

The patient was highly stressed, panting profusely so I imagine there is alot of “junk” in the ECG.  Sorry for the small size! We have recommended a Holter monitor as it may be better to see how this patient is at home in his own environment. Definitely no pericardial effusion on the echo.

I did end up sending the ECG to a cardiologist (who got the larger original size) the interpretation was:

Intermittent atrial premature beats and occasional runs of supraventricular tachycardia.
Average sinus rate  is about 150- 160 with a sinus arrhythmia. SVT rate approaches 280bpm as an instantaneous R-R interval. There is occasional second degree AV block.

 

 

 

Pankatz
April 22, 2014 at 8:53 pm -

Thanks Peter!
The patient was

Thanks Peter!

The patient was highly stressed, panting profusely so I imagine there is alot of “junk” in the ECG.  Sorry for the small size! We have recommended a Holter monitor as it may be better to see how this patient is at home in his own environment. Definitely no pericardial effusion on the echo.

I did end up sending the ECG to a cardiologist (who got the larger original size) the interpretation was:

Intermittent atrial premature beats and occasional runs of supraventricular tachycardia.
Average sinus rate  is about 150- 160 with a sinus arrhythmia. SVT rate approaches 280bpm as an instantaneous R-R interval. There is occasional second degree AV block.

 

 

 

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