Help with ECG

RE: Help with ECG

Tassadar — Mon, 29 Jan 2018 17:13:16 GMT

B-blockers are more negatively inotropic than calcium channel blocker. Digoxin probably would be preferred choice to slow down conduction through AV node if contractility is affected by myocardial disease or tachycardia. At the moment there is no murmur so unlikely to have a signifficant chamber remodelling causing this rapid rate. It is either SVT w/o heart disease (that needs treatment if sustained) or just a sinus tachycardia that does not need treatment.

RE: Help with ECG

Anthony Todd — Mon, 29 Jan 2018 17:01:38 GMT

I've seen greyhounds at the track [Clapton, back in the day] that used to tremble violently if I went near them...... and a nurse had one that screamed when I lifted it up, yet was a lovely calm animal at other times...

RE: Help with ECG

Richard Carter — Mon, 29 Jan 2018 16:52:02 GMT

?propranolol if sinus? Thought diltiazem had negative effects on cardiac muscle strength as well so output is also depressed?

RE: Help with ECG

Tassadar — Mon, 29 Jan 2018 16:07:07 GMT

I have seen this dog again for recheck. The heart rate was still high around 240-260bpm but it did gradually decrease when the dog got relaxed. Still muscle tremors. No murmur. CRT <2sec. MM pink. Showed owner how to measure HR at home and if it still high at rest at home - holter monitor for 24hr to assess how sustained this tachycardia is and if it is sustained for majority of the day then going for diltiazem to decrease HR would be a good option.

RE: Help with ECG

Anthony Todd — Fri, 26 Jan 2018 21:42:26 GMT

Could get a rough rate before that if you ask the owner to do it at home, cheaper for the owner too.....

RE: Help with ECG

Tassadar — Fri, 26 Jan 2018 20:22:06 GMT

I havw booked this case for revisit next monday. Dog is fine clinically. Just dont want to end up with tachycardia induced cardiomyopathy if the fast tachycardia is sustained. Will discuss echocardiography and holter with the owner if the rhythm is still 260bpm. Thanks.

RE: Help with ECG

Anthony Todd — Thu, 25 Jan 2018 16:20:48 GMT

I'd ring the owner and ask?

Rate doesn't need to be exact, but you may have to teach the owner to work it out if he doesn't count a full minute....

RE: Help with ECG

Jenny Harris — Thu, 25 Jan 2018 13:13:00 GMT

But this heart rate was 260 which is surely abnormal in a dog

RE: Help with ECG

Sammy82 — Wed, 24 Jan 2018 10:50:38 GMT

I vaguely remember a greyhound from when I was seeing practice who had a heart rate of over 200 bpm every time he was seen at the practice. I can't remember if ECG was avaible/performed in house but he was fitted with a halter monitor. The only times his heart rate was high was when he entered the practice. The ECG and his heart rate was perfectly normal at home.

RE: Help with ECG

Edward Jones — Wed, 24 Jan 2018 10:16:14 GMT

Looks like SVT to me, but I'm no specialist. I'd say 260 bpm is too much to be purely stress.

RE: Help with ECG

Tassadar — Wed, 24 Jan 2018 09:55:45 GMT

We have not seen this dog back since taking ECG. Owner was instructed to monitor for syncope etc. Just wondering if this is purely stress/exam related sinus tachicardia or is it SVT. P waves look normal and it seems like they are coming from sinus node. Would probably expect P waves to look abnormal if an ectopic foci would discharge at this rate. Dunno.

RE: Help with ECG

Edward Jones — Wed, 24 Jan 2018 09:01:43 GMT

I had a dog with a similar ECG that turned to have chewed a Ventolin asthma inhaler. I didn't diagnose the cause at the time. No treatment and it was fine the next day.

How is this dog today?

RE: Help with ECG

Roland Bulkyn-Rackowe — Tue, 23 Jan 2018 20:57:28 GMT

I'm not an ECG expert but that looks like a sinus tachycardia (as someone above stated, chocolate / caffeine can cause this!!). The P-QRS interval looks pretty consistent with an overlying variation in the baseline caused presumably (as said above) by the tremor.

RE: Help with ECG

Tassadar — Tue, 23 Jan 2018 20:18:17 GMT

1st and 2nd image - 50mm/sec and 1cm=1mV

3rd image 25mm/sec and 1cm=1mV

2nd image is avr, avl, avf

1st and 3rd image are leads 1, 2, 3.

RE: Help with ECG

Beats — Tue, 23 Jan 2018 19:43:15 GMT

rhythm looks fine on that strip to my untrained eye.

What is the paper speed? (25mm/s or 50mm/s)?

RE: Help with ECG

Richard Carter — Tue, 23 Jan 2018 18:53:13 GMT

cut back on the coffee and chocolates....

RE: Help with ECG

Sammy82 — Tue, 23 Jan 2018 17:19:11 GMT

No ECG expert here, but if the dog had muscle tremors during the ECG it will effect it quite a lot.