ECG Case: 40-year-old Woman with 'Extra Heart Beats'

00:01 Alright, now that we've talked about ventricular arrythmias, let's take a case.

00:05 Here's a 40-year-old vigorous female.

00:08 She's seen in the office and complains about occasional 'extra heart beats'.

00:12 She feels her heart going flip flop. Feels like the heart's doing somersaults and then pausing.

00:18 So, she has palpitations and here's her ECG.

00:23 Look at the ECG and see if you can recognize what's going on.

00:34 Notice that there are extra beats occurring early and that the QRS is very differently oriented and different shape from the normal rhythm.

00:44 And the ST segment is in the opposite direction.

00:48 If you looked at the rhythm strip down at the bottom, you'll see first there's the standard and then you'll see normal beat, normal beat PVC.

00:57 Normal beat, normal beat PVC. Normal beat, normal beat PVC.

01:02 Notice QRS is wide, very different from the normal beat, and the ST and T wave are oppositely directed from the direction that the QRS is taking.

01:13 So, these are single, premature ventricular contractions and are usually benign in the absence of heart disease.

01:20 Sometimes if the patients has been drinking a lot of coffee, taking a lot of caffeine, the patient has been smoking, or the patient has been excited or frightened, you will see some PVCs. They can be benign.

01:33 Thank you very much for attending this lecture.

01:36 I look forward to talking with you in the next one.