tag:blogger.com,1999:blog-549949223388475481.post2167803943054996087..comments2024-03-26T22:42:04.176-05:00Comments on Dr. Smith's ECG Blog: How are these cases related?Unknownnoreply@blogger.comBlogger8125tag:blogger.com,1999:blog-549949223388475481.post-39374285092393169672015-02-22T13:50:17.495-06:002015-02-22T13:50:17.495-06:00The ACC says that any corrected QT less than 390 i...The ACC says that any corrected QT less than 390 is short. <br />http://content.onlinejacc.org/article.aspx?articleid=%201139533 <br />I would guesstimate that one should be particularly worried if less than 375 <br /><br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-36967493947658889342015-02-21T11:04:34.902-06:002015-02-21T11:04:34.902-06:00Thanks for this, very interesting. I got the long ...Thanks for this, very interesting. I got the long QT but not the short.<br /><br />At what point would you say QTc is pathologically short and check the calcium? <br /><br />I also thought there are some additional p waves in top tracing, possibly 2:1, but as you say difficult to see with the artifact and no rhythm strip.Anonymoushttps://www.blogger.com/profile/16888292983934728491noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-34022640776307667612015-02-20T18:44:01.195-06:002015-02-20T18:44:01.195-06:00Only that both are related to calcium: hyper- and ...Only that both are related to calcium: hyper- and hypocalcemia.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-70949536692762301792015-02-20T18:43:10.220-06:002015-02-20T18:43:10.220-06:00Thanks, Ken!Thanks, Ken!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-26060430446137494392015-02-20T18:42:58.952-06:002015-02-20T18:42:58.952-06:00Olivier,
My inclination is to attribute it to arti...Olivier,<br />My inclination is to attribute it to artifact, of which there is quite a bit on this ECG.<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-143854224005232222015-02-20T08:54:35.743-06:002015-02-20T08:54:35.743-06:00Okay, I am stumped but very curious on how these t...Okay, I am stumped but very curious on how these two cases are related. Can you give any tips, Dr. Smith?Valeriehttp://store.chall.com/noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-60595645241178813232015-02-19T20:03:31.941-06:002015-02-19T20:03:31.941-06:00The T wave is bizarre in the first one like there...The T wave is bizarre in the first one like there was a hidden P wave. AVblock?Olivier Peyronyhttps://www.blogger.com/profile/11131579398938096686noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-85527097599156882372015-02-19T15:49:28.399-06:002015-02-19T15:49:28.399-06:00Hypocalcemia typically produces the "tent sig...Hypocalcemia typically produces the "tent sign" at the end of the desert (ie, relatively normal but prolonged ST segment followed by an otherwise unaffected T wave) - which is precisely what the TOP ECG shows. Hypocalcemia often accompanies hyperkalemia - so that T wave at the end of the long ST may be peaked in renal failure patients with both abnormalities.<br /><br />ECG-2 is a beautiful example of that short-Q-to-peak-of-T interval seen with hypercalcemia. Having looked for examples of Hypercalcemia on ECG over a period of ~ 3 decades while I was attending (and religiously checking serum Ca++ levels whenever I suspected this finding) - it is not common to see (and be able to recognize) hypercalcemia on ECG in my experience. In those cases in which I could - serum Ca++ levels were almost always quite elevated (ie, ≥13 mg/dL range) - as they were for the above example.<br /><br />NICE case!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.com