Acute Ischemic Stroke Case Studies
The patient showed all the signs of an ischemic stroke such as weakness of the whole left side of his body, which can be caused by i.e congenital diseases and strokes. The ischemic stroke was found to be located in the right middle cerebral artery (right MCA) by neurologic examination.
An ischemic stroke is when a tissue or an organ cannot be supplied with blood due to i.e a blood clot in the vessel. These leads to tissue death if not treated quickly enough, since an acute ischemic stroke can build up in a matter of hours. «9»
Alteplase for ischemic stroke treatment was concidered, but the ECG showed abnormalities. The ECG of this patient was placed as standard and the condition dextrocardia was not known beforehand. Another ECG was done that showed similar values. After MRI, the patient was diagnosed with dextrocardia situs inversus totalis. In patients with acute ischemic stroke it is essential for quick treatment with intravenous fibrinolytic therapy in response to symptoms. The patient was treated accordingly. «3» …show more content…
An unusual wide complex ECG
In this case, the patient was a 87-year old female with previously diagnosed scleroderma.
At the clinic it was discovered that she was dyspneic. Dyspneic means difficulties breathing. Following procedures done were heart and lung investigations. They showed that the patient had pneumonia (which she was being treated for) and it also showed distant heart sounds.
The patient underwent ECG analysis and it was possible to determine that the patient had dextrocardia (and not limb reversal). The ECG shows a fast heart rate and therefore sinus tachycardia. The wide QRS complex that is seen in both Figure and Figure are due to the thickening of cells in the left ventricle. This increase in size is caused by high blood pressure. This is also a left bundle branch block.
«14»
Figure. Computerized standard ECG of the patient.
Figure. Computerized reversed ECG of the patient.
After switching the electrodes, it becomes clearer that the patient has dextrocardia with a left bundle branch block and a first degree AV block with a rhythm of sinus tachycardia. First degree AV blocks are depicted in the ECG as longer PR intervals. This is because the signal from the AV node to the ventricles is further slowed down by the block. The block can be caused by the thickening of cells in the left ventricle, as can be the cause of the left bundle branch block.
The multiple conditions of this patient made it difficult to interpret the ECG. Especially the left bundle branch block complicated ECG reading due to it giving slurred R waves in some leads. It was also difficult to read it because it makes wide QRS complexes and the Q wave is absent in leads V5-V6.
There is not known to be any connection between scleroderma and dextrocardia. However, scleroderma has connections with other cardiac anomalities such as conduction disturbances that can cause arrhythmias. Scleroderma is a result of accumulation of collagen, often in the skin. It can also affect other tissues than just the skin, like the heart. This could be the cause of the thickening of cells in the left ventricle that caused the left bundle branch block and the first degree AV block. «10»
An ischemic stroke is when a tissue or an organ cannot be supplied with blood due to i.e a blood clot in the vessel. These leads to tissue death if not treated quickly enough, since an acute ischemic stroke can build up in a matter of hours. «9»
Alteplase for ischemic stroke treatment was concidered, but the ECG showed abnormalities. The ECG of this patient was placed as standard and the condition dextrocardia was not known beforehand. Another ECG was done that showed similar values. After MRI, the patient was diagnosed with dextrocardia situs inversus totalis. In patients with acute ischemic stroke it is essential for quick treatment with intravenous fibrinolytic therapy in response to symptoms. The patient was treated accordingly. «3» …show more content…
An unusual wide complex ECG
In this case, the patient was a 87-year old female with previously diagnosed scleroderma.
At the clinic it was discovered that she was dyspneic. Dyspneic means difficulties breathing. Following procedures done were heart and lung investigations. They showed that the patient had pneumonia (which she was being treated for) and it also showed distant heart sounds.
The patient underwent ECG analysis and it was possible to determine that the patient had dextrocardia (and not limb reversal). The ECG shows a fast heart rate and therefore sinus tachycardia. The wide QRS complex that is seen in both Figure and Figure are due to the thickening of cells in the left ventricle. This increase in size is caused by high blood pressure. This is also a left bundle branch block.
«14»
Figure. Computerized standard ECG of the patient.
Figure. Computerized reversed ECG of the patient.
After switching the electrodes, it becomes clearer that the patient has dextrocardia with a left bundle branch block and a first degree AV block with a rhythm of sinus tachycardia. First degree AV blocks are depicted in the ECG as longer PR intervals. This is because the signal from the AV node to the ventricles is further slowed down by the block. The block can be caused by the thickening of cells in the left ventricle, as can be the cause of the left bundle branch block.
The multiple conditions of this patient made it difficult to interpret the ECG. Especially the left bundle branch block complicated ECG reading due to it giving slurred R waves in some leads. It was also difficult to read it because it makes wide QRS complexes and the Q wave is absent in leads V5-V6.
There is not known to be any connection between scleroderma and dextrocardia. However, scleroderma has connections with other cardiac anomalities such as conduction disturbances that can cause arrhythmias. Scleroderma is a result of accumulation of collagen, often in the skin. It can also affect other tissues than just the skin, like the heart. This could be the cause of the thickening of cells in the left ventricle that caused the left bundle branch block and the first degree AV block. «10»