bigeminy info please!

[sissiesmama, ASN, RN]

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

[TazziRN, RN]

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.

[EricJRN, MSN, RN]

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

[emmycRN]

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.

[TazziRN, RN]

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

[TazziRN, RN]

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

[steelcityrn, RN]

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.

[TazziRN, RN]

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

[AnnieOaklyRN, BSN, RN, EMT-P]

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

[PCUSheryl]

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.

[TazziRN, RN]

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.

[AnnieOaklyRN, BSN, RN, EMT-P]

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