A seventy-two year old black female passed out at home while making Sunday dinner and was taken to the emergency room by her husband. Upon admission the emergency room physician noted that her heart rate was 32 bpm. EKG indicated many “p” waves between “QRS” complexes. I need help with a diagnosis.
I think a cardiologist would be the best one to interpret the EKG. The machines have a built in computer program to "read" them but often are wrong. It's best for a real person to look it over. Do you have a follow-up visit with a doctor? Your heart rate was very low which probably caused you to faint. What's causing that, I don't know. Perhaps some kind of heart block. Do follow up with a cardio.
For a perspective, abnormal heart rhythms are diagnosed by noting the rate of the P waves and QRS complexes, whether expected P waves or QRS complexes are absent and alterations in the normal 1:1 relationship between the P wave and QRS complexes.
The P wave are impulses that contract the upper chambers and the QRS complex are impulses for the ventricle to contract after filling (includes part of the P wave during filling stage). That would be the one to one relationship.
If for some reason the sinus node fails to act in the normal cardiac pacemaker, the other atrial signals can converge and may take over, and the P wave may have a different configuration. This condition would be the underlying cause for the slow heart rate and abnormal relationship and configuration with P wave and QRS complex.
The relationship between P waves and QRT complexes helps distinguish various cardiac arrhythmias.
Sounds like complete heart block to me. This is a common indication for a pacemaker. Many times patients feel a lot more energy after the implantation. It should be pretty easy to diagnose and treat. Best of luck.
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