Dispensary Corner 19 Dec 13
December 19, 2013
Tachycardia - origin unknown.
A 40 year old man whose
heart was being monitored
on continuous telemetry for
decompensated idiopathic
dilated cardiomyopathy
following removal of an infected
implantable cardiodefibrillator
was noted to have abnormal
tracing between 19:00 and 22:00
on 4 July 2012.
Delving into this timing it was
revealed that according to the
Medical Journal of Australia, the
patient had been watching the
State of Origin rugby league game
on TV.
The telemetry device shows the
onset of the tachycardia at the
start of the match coverage at
19:00, with a second peak at kickoff
(20:15).
The sinus tachycardia persisted
throughout the first half until
the half-time interlude, when
normocardia resumed.
The tachycardia reoccurred
at the start of the second half,
reaching a peak in the dying
minutes of the game, when the
patient’s home state, Queensland,
scored a field goal at 75 minutes
— followed by a missed longrange
field goal by the NSW
halfback in the final minute of the
game — securing victory by one
point for Queensland (21:55).
“Origin-induced tachycardia
should be a differential
diagnosis for asymptomatic
sinus tachycardia” the authors
concluded.
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