Question

1. A elderly patient comes into the ER complaining of repeated episodes of fainting (syncope). The Emergency Department physician admits the patient to the hospital. What type(s) of EKG do they order (e.g. diagnostic 12 lead, continuous) and why?

2. A 55yr old male comes into the ER with classic symptoms of myocardial infarction – chest pain, sweating, and shortness of breath. The Emergency Department physican admits the patient to the hospital. What type(s) of EKG do they order (e.g. diagnostic 12 lead, continuous) and why?

3. The Holter Monitor is a type of EKG used for continuous monitoring. Please describe the following:

a. A set of symptoms and their underlying cause that would cause a physician to order Holter monitoring

b. The difference between “event monitoring” and “Holter monitoring”

Reposted question 2. Thanks.

Answer 1

Q1 Answer:

For the evaluation of syncope or fainting, continue ECG should be used for the evaluation. It is used for the patient who is having a repeated history of fainting which is not able to identify by 12 lead ECG. This will helps to identify or capture or record the abnormal rhythm or beat of heart which leads to fainting to the patient by continuously monitoring the patient.

Q2 answer;

For the patient with MI symptoms, first or initially the doctor will advise for 12 leads ECG. It is because this can be able to identify the types of heart attack and where it is occurring or any previous or recent silent heart attack also can be able to identify with 12 lead ECG. Mostly 12 lead ECGs are used rule out the cardiac disease for the first time.

Q3

Answer: The set of symptoms includes dizziness, fainting, low blood pressure, prolong fatigue, palpitation continuously, or repeatedly occurs of these symptoms and the condition is not able to rule out by the other types of ECG. Then the doctor will advise Holter monitoring ECG to capture the changes in the heart by monitoring 24 hours.

Q4

Answer: The difference between the even monitoring and Holter monitoring is that event monitoring is more longer monitor the heart for about 30 days and the person have to click the button whenever the symptoms started. This will give more data during the pre sypmtomd, during symptoms and post symptoms changes in the ECG. But for Holter monitoring last long for 24-48 hours and it gives the record of continue monitoring. The patient has to do nothing.