Hey -- I an RN with a wide variety of specialties in the past, and have been in the ER the last 4 years. One thing I have come across is a pt. presenting in bigeminy. Nursing school was a long time ago, and I wanted to check if anyone may could give me pointers or tidbits from school if you are a student, or your own experiences. I am wondering bout tx meds, factors leading up to it, or anything else anybody may know.

Thanks -- I am looking forward to any responses so I can more adequately care for my patients who present to our ER with cardic complaints.

Anne, RNC

I had an episode of bigeminy a few years back. No symptoms, we were testing the BP machine at work and my pulse rate was in the 40's. Monitor showed bigeminy. I was worked up, no source. The doc offered me verapamil if I wanted but since I wasn't symptomatic I refused. I've never been checked since then but I think I go in and out of it. I know stress can be a factor.

What type of bigeminy (atrial, ventricular, junctional, etc) was this?

If you are talking about ventricular ectopic beats (or PVC's) occuring every other beat than this could indicate an electrolyte imbalance. I have seen many patients with frequent ectopy who are magnesium deficient.

Eric, I believe it was junctional. So long ago I don't really remember.

Hang on, I think I still have the EKG.......be back soon.....

Thats true emmy, mag can be the culprit for sure. And of course the worry with bigeminy is the possibility of it progressing to v tach.

Found it. It was ventricular. Everything came back normal on me: labs, echo, everything. It lasted about 48 hours before resolving.

I get ventricular ectopy and woke up one morning in what i think was a bigeminy or trigeminy ( I was at home and not work, so not monitor to look at). It usually occurs before I get Auntie flow so I think it is hormone related. maybe that is what yours was too tazi.

Swtooth

Could be potassium or magnesium imbalance; something is causing irritability of the heart muscle, could be CHF, cardiomyopathy, diseased heart valve. To treat, find the root cause and fix it if possible; If not symptomatic, no cause of alarm, just fix the problem. If symptomatic, apply O2, examine rhythm, rate, etc. If rate is too fast, give beta-blockers, and continue to dx root cause and reverse it.

I get ventricular ectopy and woke up one morning in what i think was a bigeminy or trigeminy ( I was at home and not work, so not monitor to look at). It usually occurs before I get Auntie flow so I think it is hormone related. maybe that is what yours was too tazi.

Swtooth

Hmm......never thought of that, I'll have to think abouth that.

Honest to god. I know auntie flows comming not only because I get really grumpy, have back pain, and eat everythig in site, but I get PVCs and the bigeminy or trigeminy. Same thing happens to my sister.

Swtooth

Sometimes hyperthyroidism can cause ventricular arrhythmias, too. Maybe other hormones can play a part as well.