Case 3
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Question 1 of 3
1. Question
A 44-year-old female presents with palpitations, dizziness and breathlessness on exertion. She gives a history of Wolff-Parkinson-White syndrome. She is a longstanding smoker and has recurrent chest infections. She has had a cough productive of discoloured sputum for 3 days.
On examination, she has:
- Pulse rate of 190/min
- Respiratory rate of 26
- BP = 100/70
- An SaO2 of 93% on air, rising to 95% on 15L of oxygen.
- Her temperature is 38.4oC
Auscultation of her chest reveals a few bilateral scattered expiratory crackles but nothing focal.
Click on the ECG to enlarge.
What is the arrhythmia?
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Question 2 of 3
2. Question
Which one of the following is the most appropriate initial intervention for this patient?
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Question 3 of 3
3. Question
You successfully cardiovert her back into sinus rhythm with 6 mg adenosine and her subsequent ECG is shown. Click on the ECG to enlarge.
Why was there no delta wave on her presenting ECG?
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