PATIENT: Luke Hogg
HISTORY: malaise, auscultatable arhythmia with pulse deficit
There is no underlying cardiac disease here however there are very frequent VPC’s with predominantly a trigeminy pattern (every third beat is a VPC) although couplets and triplets are seen making this patient at risk for runs of ventricular tachycardia. Common causes for VPCs in the absence of primary cardiac disease are renal failure, splenic masses, and other systemic or abdominal disease. Blood sampling and abdominal ultrasound are recommended to evaluate for these potential causes and if normal Holter monitoring may also be advisable to evaluate for symptomatic VTach so that therapy may be initiated.
Comments: cardiac chambers, valves and outflow tracts appear normal and systolic function is good. Heart rate is approximately 100bpm, underlying sinus rhythm.
LA:Aortic ratio (RPS SA, normal <1.6) 1.6
LA:Ao ratio (RPS LA, normal <2.5) 1.8
FS 53%, EPSS 0.1cm.
WALL THICKNESS AND CHAMBER DIMENSIONS COMMENTS: lvdd 4.1cm
No abnormal jets or turbulent flow demonstrated
MITRAL INFLOW: Mitral Regurgitation? no
AORTIC OUTFLOW: Max Velocity 1.95m/s. Aortic Insufficiency? no
TRICUSPID INFLOW: Tricuspid Insufficiency? no
PULMONIC OUTFLOW Max Velocity 1.4m/s. Pulmonic Insufficiency? no
trace quality : good
HR: underlying sinus rhythm 108bpm, frequent VPCs, every third beat, occasional couplets, triplet
complex sizes and durations within normal limits