#fridayimagechallenge (with answers)

55yo female presents with 5 syncopal episodes in the last 24 hours. EKG on presentation below

alternans

interesting ecg/image? send to utswecg@gmail.com

Answer: electrical alternans as many of you knew

Here is a great NEJM article on electrical alternans, what I found most interesting is the mechanical explanation for the rhythm, the heart is actually moving back and forth within the effusion leading to the beat to beat QRS variation. definitely worth a watch!

http://www.nejm.org/doi/full/10.1056/nejmicm1408805#t=article

 

interesting ekg/image? send to utswecg@gmail.com