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A 44 year old previously healthy woman is referred by her doctor to the emergency department for feelings of anxiety and a pulse of 130-160. She is sweaty and tremulous and admits to recent weight loss and a neck mass. What does the EKG show and what is your diagnosis? Rate: 150 Rhythm: Sinus tachycardia Axis: Normal P: Normal PR: Normal QRS: Normal ST: Slight lateral depression EKG Diagnosis: Sinus tachycardia Clinical Diagnosis: Thyrotoxicosis with sinus tachycardia Practice points: -The EKG can only be interpreted in conjunction with the clinical picture. It is unusual to have a sinus tachycardia of 150 at rest and the differential diagnosis includes atrial flutter with 2:1 block and SVT. |