Quote:
Originally Posted by Patriot007
Patient has been feeling down lately. History of depression. Current Effexor use.
There is a terminal R wave in AVR. This can be seen in sodium channel blockade e.g. TCA (tricyclic antidepressants ) toxicity.
Possible Effexor OD or had some old TCA and downed the bottle.
Concern for ventricular arrhythmia from sodium channel blockade toxicity.
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100% agree this is a major consideration for this patient especially considering the wide QRS of unknown chronicity.
Differential:
Long QT (QTc = 652)
Hypertrophic Cardiomyopathy
Overdose, especially TCA
MVP -> Arrhythmia
Anyone want to take the low hanging fruit and see if you can find any ECG signs this hypertensive hyperlipidemic diabetic guy with chest pain could be having a heart attack?
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