Echocardiogram of Ventricular Tachycardia while still being paced. You're asked to emergently echo this patient who developed sudden PEA arrest in the ICU after cardiac surgery. What's going on? What's the rhythm? What do you think happened? Answer — Would it help if I told you this patient has an pacer? Ahh!!! Now the "PEA" rhythm and echo make more sense, but you had to look. This patient has VT but is still being paced. You can see the rhythm underlying the pacer spikes as well as VT appearance of the left ventricle. The other interesting thing is that even though this patient has a bad arrhythmia the echo still gives you valuable information. Look at the size and behavior of the right and left ventricles. Not normal! You can see RV failure even in this situation. Could be PE, could be ischemia, maybe arrest from severe pulmonary hypertension. In this case the patient thrombosed a fresh proximal RCA stent. - Dr. Josh Zimmerman @Periop_Echo #Echocardiogram #Ventricular #Tachycardia #VTach #POCUS #Paced #Clinical
