Pt was told to come to hospital after observed bp/hr at pcp's office. Yeah I have not been oriented/asked out loud how/why exactly some pt.s of this type are allowed to come over unsupervised if they warrant inpatient status.
1. In an old copy of "the ICU book" that I picked up it says that hypotension due to loss of atrial kick occurs above heart rates of 180. How empirically studied this is I do not know. I would have to assume this is in healthy hearts as I have seen old tired hearts hypotensive at fast rates that are south of 180. But, these pt.s often have the typical comorbidities.
2. BP was double checked manual at rest. I do like the idea that kidney malfunction and the RAAS system could have some input on pressures that lack of filling/pumping time of the heart at that rate may not have. I did not think of that.
3. This pt. was about to receive a cardizem bolus followed by gtt when she converted on her own to NSR in the 70s. At that point she told us that this was the third or so time that this has happened. (Thanks for the info :spin
She's asymptomatic when she does this.
4. D/cd an hour later. F/u with cardiologist. I would think an EP study should be in their future? I would have been hesitant to go out the door...