Dooger

Double 'P' waves?!?

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That is possibly the funniest thing I have ever heard doc. :D

In absence of the ECG, I'm still convinced this may be atrial enlargement.

In absence of the ECG it could simply be the bat signal over gotham city. Quick Robin, to the bat cave, its the EKG Riddler poised to strike...................

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That is possibly the funniest thing I have ever heard doc. :D

In absence of the ECG, I'm still convinced this may be atrial enlargement.

In absence of the ECG it could simply be the bat signal over gotham city. Quick Robin, to the bat cave, its the EKG Riddler poised to strike...................

It's no joke, for about 3 weeks after the transplant they will have 2 p waves.

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It's no joke, for about 3 weeks after the transplant they will have 2 p waves.

I would think that to have a second P with a similar morphology would require a significant portion of the atria to be existing as well wouldn't it?

On that same note, and I'm pulling this out of my rear as I heard it 'somewhere' a million years ago, don't they leave a large part of the posterior portion of the heart when doing a replacement? I'm not sure of course, but might this make sense for the second P wave?

And lastly, is there an easy answer for why the SA node is left with a replacement? Maybe it's relationship to the Vagus nerve? Hell, I don't know...this just caught my attention...

Thanks for the post Doc..pretty interesting!

Dwayne

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It always happens that I see reference to something, don't have time to read it, then see it in the field. Had one just the other day. They were two distinct, but back to back p-waves at regular intervals in relation to everything else. It was almost like a McDonald's "m". I can't remember if they were connected or not....the one I saw might have just be mitrale. I think i was able to get the EKG for it, gotta look through my clipboard papers.

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Its difficult to comment on this patient with the limited amount of information available. I would be interested in seeing a copy of her EKG tracing as well as her medication list. Based on what you have told us it sounds to me like your patient was experiencing a second degree heart block. Did your patient have any history of tachycardia or any ablation therapy? 

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