Could someone please interpret this EKG for me??

[KatieC]

I'm an EMT-B for a small volunteer ambulance service, planning to start classes to become an MICT in the fall. Anyway, last night we had our monthly meeting. I was sitting there in my chair and all of a sudden I got incredibly dizzy. I felt like if I stood up, I would pass out. I usually have really low blood pressure, running about 100/60. I figured maybe it was even lower, and that was why I was dizzy. The feeling didn't go away after a few minutes and I asked our director to take my blood pressure. It was 150/86. Extremely high for me. I felt very dizzy and shaky, and kind of "floaty".....hard to describe, but kind of disconnected, and like everyone around me was floating. I had these really weird, disconnected thoughts going through my head. My friends finally convinced me to hook myself up to the monitor (our AED has a 3-lead EKG on it). So I did, and my heart rate was running about 110-125. But every minute or so, it would drop down to about 70-80. When it did, I felt even dizzier and "floatier." I also felt a little nauseous. No pain or tingling in my fingers or anything like that. No other symptoms. Finally they put me on O2 and while this made me even dizzier, it brought my heart rate below 100. I stayed hooked up to the monitor for about 1-1/2 hours, until finally my blood pressure went down to about 130 and I wasn't quite as dizzy.

I've never had any kind of symptoms like this before. I didn't take any kind of unusual meds or food or do anything out of the ordinary yesterday. I will very occasionally have PVCs (although I haven't been officially diagnosed). My heart didn't really feel like it was racing, so I was surprised to see it was that fast. No medical history whatsoever, no health problems, no family history of heart problems, etc. I'm 24 years old (well, I'll be 24 Friday!!). I have, however, been under a lot of stress in the past year. I've gone through the death of my mother from cancer, a divorce, father remarried and has nothing to do with the rest of our family, grandmother died of cancer, sister moved 1000 miles away, went through a really rough breakup just a few weeks ago. So I've been slightly stressed to say the least. That's the only unusual thing I can think of.

Anyway, our service has lost the 1 paramedic and several EMT-Is that we used to have, so no one is really trained to read EKGs. I would appreciate your guys' help in telling me what this says. Thanks in advance.

[KatieC]

Ok, so I'm computer illeterate...I have the EKG strip scanned and saved under my pictures in my computer. How do I post it here?

ETA: I put them in my user pix, but don't think they are big enough in there. Help???

[ncmedic309]

Use this website to upload your pic and then post the appropriate link in the forum...

ImageShack

[EMS49393]

Sinus arrhythmia.

Crash course:

P-wave is present, it's sinus in origin. It's upright and uniform, so it's coming from the SA node.

ORS complex is normal, the ventricles are depolarizing properly.

T-wave is upright, uniform, the ventricles are re-polarizing.

It's irregular, so it's an arrhythmia. In the one labeled EKG 4, there are two unifocal PVC's present. Your SA node probably didn't fire fast enough, and the ventricles decided to depolarize without the SA node, that's a PVC. They're unifocal, meaning they look alike, so they're coming from the same point in the ventricles.

Anything could have caused your symptoms, including your blood pressure. However your blood pressure could have been caused by your arrhythmia. IMHO you should take the information you have and talk to your physician. See if he'll set you up with a cardiologist for further testing. It's possible to have cardiac problems in your 20's. An AMI is not the only cardiac problem there is. There are also conduction pathway problems, and re-entry pathway problems. Both of those can present in children as well as adults. Without a 12-lead it's often impossible to detect a some conduction re-entry pathway issues, such as WPW.

BTW, that was pretty cool reading them sideways!

[chbare]

KatieC, I agree with EMS49393. It does indeed look like sinus dysrhythmia. The down and dirty things you need to ask when looking at a strip are, what is the rate and does it correspond to the pulse that I palpate, Is the rhythm regular or irregular, is there a normal P wave for every normal looking QRS, is the QRS normal, are there any T wave abnormalities (ST elevation, depressed T waves, etc), and what are my intervals. P waves are present for every QRS, so the underlying rhythm is sinus. The strip looks like lead II, so the upright morphology of the waves are normal for the lead. It does indeed look like you have 2 unifocal PVC's in strip number four. Unfortunately, a rhythm strip in lead II tells us as much about your general health as your user name and avatar. If you are concerned, get a complete exam performed by your PMD/PCP.

Take care,

chbare.

[EMS49393]

:thumbup: I like ya! Anyone that agrees with me is alright. LOL

[chbare]

EMS49393, thank you.

Take care,

chbare.