Mitral valve disease and left sided dilation on echo
ECG showed an irregular sinus rhythm, 80 bpm, paper speed 25mm/s and intermittent VPC. Is this a pronounced sinus arrhythmia with VPCs?
Would you advise investigating for systemic disease?
Thanks for all the cardio help!
1o year old MN GSD x with murmur
Mitral valve disease and left sided dilation on echo
ECG showed an irregular sinus rhythm, 80 bpm, paper speed 25mm/s and intermittent VPC. Is this a pronounced sinus arrhythmia with VPCs?
Would you advise investigating for systemic disease?
Thanks for all the cardio help!
veteurope1
3 responses to “MVD arrhythmia”
Hi
What I see is pronounced
Hi
What I see is pronounced sinus arrhythmia with intermittend premature complexes which differ in their morphology in a way that the main amplitude is negative in lead II and the T waves are positive as opposed to the remaining complexes. P-waves are missing in front of these complexes. Yet, they are no extremely wide. Based on these findings, they are very likely of ventricular origin.
Possible explanations are:
cardiac: Myocardial damage due to chonic volume overload or independent of the valvular disease seen. Genetic. arrhythmia extremely unlikely based on the patient’s age.
If Holter-ECG feasible: Base treatment on results. If <1000/day without any coupling or bigemini: Add Magnesium at 200 mg/day and keep potassium high normal, then recheck. If > 1000/day and/or coupling/bigemini: Start with Mexiletine or Flecainide
If Holter-ECG not feasible/affordable: If no clinical signs like episodic weakness or syncope, no couplings or bigemini visible, start with Magnesium, keep potassium high normal and re-chek with 5 min ECGs. If couplings/bigemini visible and/or clinical signs,start with Mexiletine or Flecainide.
Good luck,
Peter
Hi Peter,
That is really
Hi Peter,
That is really helpful thank you. In which instances do you recommend the magnesium +/- potassium supplementation? Do you check blood levels of magnesium?
My reasons to supplement Mg/K
My reasons to supplement Mg/K arae:
.) Dogs who receive more than. 4mg/kg Furosemide/day
.) Dogs with arrhythmias which are too benign to warrant antiarrhythmic therapy.
Of course, it’s always advisable to check potassium levels before supplementation. But, honestly, I usually do not check Magnesium
3 responses to “MVD arrhythmia”
Hi
What I see is pronounced
Hi
What I see is pronounced sinus arrhythmia with intermittend premature complexes which differ in their morphology in a way that the main amplitude is negative in lead II and the T waves are positive as opposed to the remaining complexes. P-waves are missing in front of these complexes. Yet, they are no extremely wide. Based on these findings, they are very likely of ventricular origin.
Possible explanations are:
My personal algorithm/treatment would be:
Good luck,
Peter
Hi Peter,
That is really
Hi Peter,
That is really helpful thank you. In which instances do you recommend the magnesium +/- potassium supplementation? Do you check blood levels of magnesium?
My reasons to supplement Mg/K
My reasons to supplement Mg/K arae:
.) Dogs who receive more than. 4mg/kg Furosemide/day
.) Dogs with arrhythmias which are too benign to warrant antiarrhythmic therapy.
Of course, it’s always advisable to check potassium levels before supplementation. But, honestly, I usually do not check Magnesium
Peter