Abstract
BackgroundThe electrocardiogram (ECG) is useful in the diagnosis of cardiac and non-cardiac conditions. Rigors due to shivering can cause electrocardiogram artifacts mimicking various cardiac rhythm abnormalities.Case presentationWe describe an 80-year-old Sri Lankan man with an abnormal electrocardiogram mimicking narrow complex tachycardia during the immediate post-operative period. Electrocardiogram changes caused by muscle tremor during rigors could mimic a narrow complex tachycardia.ConclusionsIdentification of muscle tremor as a cause of electrocardiogram artifact can avoid unnecessary pharmacological and non-pharmacological intervention to prevent arrhythmias.
Highlights
The electrocardiogram (ECG) is useful in the diagnosis of cardiac and non-cardiac conditions
Following surgery under spinal anaesthesia, he was brought to the Intensive Care Unit (ICU) for routine observation
Our patient developed shivering that caused an artifact in the ECG that mimicked a narrow complex tachycardia, which alerted the medical officer to urgently contact the physician
Summary
The electrocardiogram (ECG) is an important bedside investigation technique used for the diagnosis of cardiac diseases. ECG rhythm abnormalities can occur in many non-cardiac conditions mimicking cardiac pathology, including activity of muscles. The possibility of an artifact causing ECG findings should be considered in an otherwise asymptomatic patient who is haemodynamically stable. This case report describes a patient who had rigors during the post-operative period and developed ECG changes that were initially thought to be an arrhythmia. The ECG changes reflected artifacts caused by activity of muscles. Case presentation We report a case of an 80-year-old man who underwent a hemiarthroplasty. He had no drug or food allergies. The ECG changes gradually resolved, and ECG was normal when repeated 30 min later
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