Tremor electrocardiogram: Difference between revisions

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{{CMG}} {{AE}} {{ZMalik}}
{{CMG}} {{AE}} {{ZMalik}}
==Overview==
There are no [[ECG]] findings associated with tremor. However, tremor can mimic [[ventricular tachycardia]] on [[ECG]] and cause an [[artifact]]. It is important to obtain an [[ECG]] in [[patients]] [[diagnosed]] with tremor before starting [[medications]] like [[propranolol]] to investigate for [[bradycardia]].
==Electrocardiogram==
*Tremor can mimic [[ventricular tachycardia]] on [[ECG]] appearing as a broad [[QRS complex]] and cause an [[artifact]]. It must be differentiated by finding normal [[QRS complexes]] hidden between [[artifact]] waves and looking for unstable baseline at the beginning of the [[ECG]] recording. <ref name="pmid25691788">{{cite journal| author=Martens P, Sinnaeve P| title=Tremor mimicking ventricular tachycardia. | journal=CMAJ | year= 2015 | volume= 187 | issue= 10 | pages= E326 | pmid=25691788 | doi=10.1503/cmaj.140768 | pmc=4500729 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25691788  }} </ref>
*[[Hyperthyroidism]] can appear as [[sinus tachycardia]], [[atrial flutter]] or [[atrial fibrillation]] on [[ECG|ECG.]] <ref name="pmid23593140">{{cite journal| author=Zhang Y, Post WS, Cheng A, Blasco-Colmenares E, Tomaselli GF, Guallar E| title=Thyroid hormones and electrocardiographic parameters: findings from the third national health and nutrition examination survey. | journal=PLoS One | year= 2013 | volume= 8 | issue= 4 | pages= e59489 | pmid=23593140 | doi=10.1371/journal.pone.0059489 | pmc=3625180 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23593140  }} </ref>
*[[Stress]] and [[anxiety]] can cause [[sinus tachycardia]] on [[ECG]].
*It is important to obtain an [[ECG]] in [[patients]] [[diagnosed]] with tremor before starting [[medications]] like [[propranolol]] to investigate for [[bradycardia|bradycardia.]] <ref name="pmid21321834">{{cite journal| author=Puschmann A, Wszolek ZK| title=Diagnosis and treatment of common forms of tremor. | journal=Semin Neurol | year= 2011 | volume= 31 | issue= 1 | pages= 65-77 | pmid=21321834 | doi=10.1055/s-0031-1271312 | pmc=3907068 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21321834  }} </ref>


Tremor can cause ECG artifacts that mimic a broad QRS complex tachycardia. Characteristics allowing differentiation from a broad QRS complex tachycardia include the finding of normal QRS complexes between artifact waves (Figure 1, small arrows) or an unstable baseline at the beginning of the ECG recording (not shown).
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 02:00, 18 February 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Overview

There are no ECG findings associated with tremor. However, tremor can mimic ventricular tachycardia on ECG and cause an artifact. It is important to obtain an ECG in patients diagnosed with tremor before starting medications like propranolol to investigate for bradycardia.

Electrocardiogram

References

  1. Martens P, Sinnaeve P (2015). "Tremor mimicking ventricular tachycardia". CMAJ. 187 (10): E326. doi:10.1503/cmaj.140768. PMC 4500729. PMID 25691788.
  2. Zhang Y, Post WS, Cheng A, Blasco-Colmenares E, Tomaselli GF, Guallar E (2013). "Thyroid hormones and electrocardiographic parameters: findings from the third national health and nutrition examination survey". PLoS One. 8 (4): e59489. doi:10.1371/journal.pone.0059489. PMC 3625180. PMID 23593140.
  3. Puschmann A, Wszolek ZK (2011). "Diagnosis and treatment of common forms of tremor". Semin Neurol. 31 (1): 65–77. doi:10.1055/s-0031-1271312. PMC 3907068. PMID 21321834.